Radiation Caries — MFDS Part 1 MCQ

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ModerateHuman DiseaseRadiation CariesMFDS Part 1

A 58-year-old patient received radiotherapy involving the major salivary glands for an oropharyngeal carcinoma nine months ago. They now have persistent xerostomia and rapidly progressive, circumferential cervical dental breakdown affecting multiple teeth, with additional lesions at some cusp tips and incisal edges. What is the most likely diagnosis?

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Correct answer: B — Radiation-related caries

The diagnosis is radiation-related caries. Head and neck radiotherapy can cause persistent salivary gland hypofunction, reducing salivary clearance, buffering and remineralisation. The resulting caries may progress rapidly and characteristically affect cervical smooth surfaces circumferentially, with lesions also occurring at cusp tips and incisal edges. Erosive tooth wear produces smooth surface loss or cupping rather than rapidly progressive carious breakdown. Conventional root caries is confined to exposed root surfaces and is usually associated with gingival recession. Amelogenesis imperfecta is a developmental, usually generalised enamel defect present from tooth formation rather than arising after radiotherapy. Abrasion typically causes localised, well-defined non-carious cervical defects related to mechanical wear.

Reference: Faculty of Dental Surgery, Royal College of Surgeons of England. The Oral & Dental Management of Patients Before, During and After Cancer Therapy, sections 5.4 and 5.18. February 2026. https://www.rcseng.ac.uk/-/media/Files/RCS/FDS/Publications/The-oral-and-dental-management-of-patients-before-during-and-after-cancer-therapy.pdf