Abstract
PURPOSE: To prospectively evaluate the effect of a preventive jaw-training intervention program on the development of temporomandibular disorders (TMD) in patients treated for head and neck cancer (HNC). METHODS: We randomized 58 consecutive patients with squamous cell carcinoma in the head and neck area into two groups before initiation of a curatively intended oncologic treatment: training with a jaw mobilizer once a day or a control group without active exercise. A comprehensive examination according to diagnostic criteria for temporomandibular disorders (DC/TMD) was conducted at baseline (before oncologic treatment) 6 and 12 months after completed radiation therapy (RT). The patients recorded training frequency in a diary. RESULTS: There were significant differences in the changes of maximal incisal opening (MIO) between the intervention and control groups at 6 and 12 months compared to baseline (p = 0.010 and p = 0.012, respectively) with more deterioration in the control group. The control group had a higher prevalence of TMD diagnosis at the 6-month follow-up (p = 0.010) and a close to significant level at the 12-month follow-up (p = 0.055). CONCLUSION: This unique study, which evaluates the effect of a preventive jaw-training program for prevention of TMD in patients with HNC undergoing high dose RT, found that the preventive jaw-training program could prevent the deterioration of MIO and development of TMD. IMPLICATIONS FOR CANCER SURVIVORS: This preventive exercise program could prevent the deterioration in MIO and the development of TMD in HNC patients, leading to less pain and better jaw function.