Efsun Somay¹*, Erkan Topkan², Sibel Bascil³ and Ugur Selek⁴

¹Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent
University, Turkey
²Department of Radiation Oncology, Faculty of Medicine, Baskent University,
Adana, Turkey
³Department of Periodontology, Faculty of Dentistry, Baskent University, Turkey
⁴Department of Radiation Oncology, School of Medicine, Koc University, Istanbul,
Turkey

*Corresponding Author: Efsun Somay, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Turkey.

Received: April 06, 2026 Published: May 04, 2026

Abstract

Xerostomia is a prevalent and frequently persistent complication among cancer survivors treated with chemoradiotherapy, particularly those with head and neck malignancies. Although commonly described as “dry mouth,” xerostomia reflects salivary gland hypofunction accompanied by qualitative alterations in salivary composition. Xerostomia refers to the subjective perception of oral dryness, whereas salivary gland hypofunction denotes objectively measurable reduction in salivary flow; these entities, although related, are not interchangeable. These changes disrupt oral homeostasis and contribute to oral morbidity, functional impairment, and reduced quality of life. ultimately impairing salivary secretion and protective functions. While concurrent chemotherapy does not directly injure salivary glands, it may exacerbate symptom severity through mucosal toxicity, systemic inflammation, dehydration, and reduced treatment tolerance. The clinical impact extends beyond subjective dryness: compromised lubrication, buffering capacity, antimicrobial defense, and remineralization contribute to difficulties with mastication, swallowing, speech, and sleep. Xerostomia is also associated with radiation-related dental caries, periodontal disease progression, and tooth loss, particularly in long-term survivors. This narrative review synthesizes current evidence on the mechanisms, clinical consequences, and evidence-based management of chemoradiotherapy-induced xerostomia across the cancer continuum. Emphasis is placed on survivorship-oriented care, including standardized assessment of salivary dysfunction, preventive dental strategies, and multidisciplinary supportive approaches. Despite advances in radiotherapy planning and symptomatic therapies, durable restoration of salivary gland function remains an unmet clinical need, underscoring the importance of risk-adapted prevention, long-term oral surveillance, and integration of oral health outcomes into comprehensive survivorship care models. This narrative review aims to synthesize the current evidence on the mechanisms, clinical consequences, assessment, and management of chemoradiotherapy-induced xerostomia in head and neck cancer survivors. A structured literature search was performed using major databases (PubMed, Scopus, and Web of Science), focusing on studies published in the modern radiotherapy era.

Keywords: Xerostomia; Salivary Gland Hypofunction; Chemoradiotherapy; Head and Neck Cancer; Survivorship; Radiation-Related Caries; Periodontal Disease; Supportive Care

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Citation

Citation: Efsun Somay., et al. “Beyond Dry Mouth: Clinical Consequences and Management of Chemoradiotherapy-Induced Xerostomia in Head and Neck Cancer Survivors: A Narrative Review". Acta Scientific Cancer Biology 10.2 (2026): 51-63.

Copyright

Copyright: © 2026 Efsun Somay., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.