European Journal of Prosthodontics and Restorative Dentistry

A Service Evaluation of Dental Assessments Prior to Treatment for Head and Neck Cancer in NHS Grampian

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Cover Date

June 2022

Print ISSN

0965-7452

Electronic ISSN

2396-8893

Vol

30

Issue

2

Abstract

To minimise the risk of Osteoradionecrosis (ORN) following radiotherapy, dental assessments are carried out by Restorative Consultants to determine teeth of poor prognosis requiring extraction before the commencement of radiotherapy for oncological treatment. Social deprivation is a high-risk factor for poor oral health and head and neck cancer (HANC), consequently highlighting the importance of the prehabilitation pathway, including dental assessment. Aim: To retrospectively assess the demographics of the HAN oncology patient cohort, treatment modality, prehabilitation pathway and timeframe within NHS Grampian and highlight the role of the Restorative Dental Consultant. Materials and Methods: Retrospective assessment of 120 HANC patients’ clinical records from May 2018 to December 2019. The patients were selected as a continuous cohort from Restorative Consultant dental assessment clinics. Results: Radiotherapy
was the most common treatment modality, with 91% of patients receiving treatment; the mean time between completing dental extractions and commencing radiotherapy for oncological treatment was 17.98 days. Conclusion: The HANC prehabilitation pathway should be conducted in a timeframe that allows patients to have sufficient time for healing between extractions and oncological treatment commencing to reduce ORN risk. The study also demonstrates an increased incidence of HANC in areas of higher social deprivation.

Keywords
Social Deprivation
Restorative Dentist
Prehabilitation Pathway
Restorative Dental Assessment
Head and Neck Cancer Dental
Assessment