Dental assessment pre radiotherapy for head and neck cancer

Abstract

Statement of the problem Head and neck cancer (HNC) and its treatment can dramatically change a patient’s appearance, speech, and oral function. Radiotherapy (RT) as a primary or adjuvant management strategy can result in osteoradionecrosis (ORN), salivary gland hypofunction, and can contribute to dental caries, among other sequelae. Assessment by a dentist prior to RT is important to remove suspect teeth in the field of radiation and commence preventive and restorative care for the long term. This can reduce subsequent ORN risk, reduce oral complaints during RT, and optimise oral health-related quality of life (OHRQoL). Purpose of the study This is a large-scale cohort study investigating dental treatment provided to a group undergoing RT for primary tumours of the head and neck. Materials and methods A retrospective chart review was carried out of all patients who had presented at the pre-RT dental clinic at Dublin Dental University Hospital from 2018 to 2019. Results A total of 490 patients were included. The mean age at presentation was 63 years (SD = 11). Approximately 50% of patients required removal of at least one unit and 12.7% of patients required basic dental restorations prior to commencement of RT. Most patients (93%) were assessed and treated within the requested timeframe. Conclusions Pre-RT assessment of HNC patients is important, as many require dental treatments such as extractions or basic restorations. Early planning for dental review should be considered to allow adequate time for assessment and proper treatment of long-standing dental issues.