A longitudinal study was performed to assess the effects of radiation-induced xerostomia on the human oral microflora. Pronounced microbial population shifts were found in each of five intraoral sites tested. Cariogenic microorganisms gained prominence at the expense of noncariogenic microorganisms in concert with the saliva shutdown. These changes occurred before the onset of clinical caries irrespective of whether or not a topical fluoride gel was used as a caries preventive.
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