Oral health in patients with head and neck cancer: A review of current management

Abstract

5561 Background: Radiation therapy (RT) for head and neck cancer (HNC) is associated with a high incidence of long-term adverse events, including xerostomia, mucositis, and dental caries. The importance of a comprehensive dental evaluation and rigorous oral care before, during, and after RT is widely recognized. However, relatively few data are available on the extent of oral health interventions or compliance in patients with HNC. Methods: A Medline literature search was performed using HNC, oral complications (eg, xerostomia, mucositis, stomatitis, caries, gingivitis), and oral healthcare (eg, oral care, oral health, dental care, dental health) search terms. The search was limited to 1984–2004, adults ≥18 y and English language publications. Results: Of 331 publications identified, 19 were clinical trials, surveys, or case reports that described oral/dental interventions in irradiated patients with HNC and/or patient compliance with oral care regimens. There is considerable variation in the approach to management of oral/dental complications, and a lack of established and well-accepted clinical guidelines. The rate of pre-irradiation dental consultation in patients with HNC is low (12.1% to 44%). Between 50% and 76% of patients are noncompliant even when routine dental care is available, and about half (51%) of patients are lost to dental follow-up. Conclusions: Dental care and oral hygiene are crucial to the prevention and management of long-term adverse events following RT for HNC. These findings indicate that many patients do not receive adequate care or instruction in oral hygiene, and highlight the importance of integrating good dental care education and practices into the management of patients with HNC. No significant financial relationships to disclose.