A Patient-Customized Oral Appliance to Prevent Trismus and Improve Salivary Function in Head and Neck Cancer Survivors.

Abstract

Chemoradiotherapy for head and neck cancer often causes trismus and xerostomia-induced dental caries, impairing quality of life. Current interventions have compliance and efficacy issues. This study developed a patient-customized oral appliance to address both conditions. A fluoride delivery appliance was designed using an interactive approach and decision-matrix scoring. A longitudinal clinical study (n = 30) evaluated its impact on mouth opening, salivary flow, and patient-reported outcomes. The final design featured a posterior occlusal support, enhancing mandibular mobility and fluoride delivery. At 5 years postradiotherapy, benefits included improved saliva flow, reduced dental caries, pain-free full mouth opening, and enhanced eating and speaking functions. The Gothenburg Trismus Questionnaire scores indicated superior recovery over standard fluoride trays (p = 0.0002). This novel oral appliance offers a dual-function, patient-customized approach to improving mandibular mobility and salivary function, ultimately enhancing long-term quality of life for head and neck cancer survivors after chemoradiotherapy.