Oxidative Stress, Microbiome Dysbiosis, and Oral Mucositis After Radiotherapy: Cause, Consequence, or Vicious Cycle?

Cintaonela Artti Benecia¹, Retno Pudji Rahayu^2*

Abstract

Radiation-induced oral mucositis is a common complication of radiotherapy in patients with head and neck cancer, resulting from complex interactions between cellular damage, oxidative stress, inflammation, and oral microbiome alterations. This narrative review examines the interplay between radiation-induced oxidative stress and oral microbiome dysbiosis in EBRT-induced oral mucositis. Radiation generates reactive oxygen species (ROS) that cause cellular and DNA damage and activate inflammatory pathways, while radiation-induced changes in saliva, pH, and mucosal immunity promote microbiome dysbiosis. Conversely, dysbiosis may further increase oxidative stress and inflammation, suggesting a bidirectional interaction that forms a vicious cycle and contributes to progressive mucosal injury and ulceration. Emerging strategies, including oxidative stress modulation, probiotics, predictive biomarkers, and local drug delivery systems, show potential but remain supported by limited and variable clinical evidence. Understanding this interaction may support the development of personalized multi target strategies for the prevention and treatment of radiation-induced oral mucositis.

Keywords

oral mucositis; oxidative stress; oral microbiome dysbiosis; radiotherapy; host-microbe interaction

Cite This Article

Benecia, C. A., Rahayu, R. P. (2026). Oxidative Stress, Microbiome Dysbiosis, and Oral Mucositis After Radiotherapy: Cause, Consequence, or Vicious Cycle?. International Journal of Scientific Advances (IJSCIA), Volume 7| Issue 5: Sep – Oct 2026, Pages 514-520 URL: https://www.ijscia.com/wp-content/uploads/2026/09/Volume7-Issue5-Sep-Oct-No.1071-514-520.pdf

Volume 7 | Issue 5: Sep – Oct 2026