Many years ago removable lead shields were adapted over the teeth in an attempt to protect them from radiation during oral cancer therapy. Presently, is that procedure still used in modern treatment?
The lead shield mentioned was used many years ago when the treatment energy was very low-orthovoltage energies of 150 kVp or so. With that energy the lead furnished a partial shielding effect and protected the mucosal tissues from excessive doses. Given the 6 MV energies typically used today for head and neck cancer treatment, the lead would act as a buildup material and would enhance the dose to the mucosal tissues. What is used on occasion today is a fluoride stent, which bathes the teeth in the fluoride ion and protects them partially from cavity formation due to the lack of saliva, a radiation consequence. Also used on occasion are spacer devices, which separate the lower and upper jaw so the radiation field can more easily spare one or the other depending on the tumor location. If the tumor is superficial and low-energy orthovoltage x rays are the treatment energies of choice, then the use of a wax-coated stint may still be used with some benefit to the patient. However, few facil
