Presenting pre-radiotherapy dental status of head and neck cancer patients in the novel radiation era (2024)

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Abstract Access options Additional access options: Similar content being viewed by others An audit of dental assessments including orthopantomography and timing of dental extractions before radiotherapy for head and neck cancer Dental loss after radiotherapy for head and neck cancer An audit into the timing of dental extractions pre-head and neck radiotherapy and the prevalence of osteoradionecrosis References Author information Authors and Affiliations Corresponding author Ethics declarations Rights and permissions About this article Cite this article This article is cited by A cross-sectional study of the association of dental health factors with progression and all-cause mortality in men diagnosed with HPV-associated oropharyngeal cancer The clinical effect of radiotherapy on pulpal microvasculature: a systematic review The presenting dental status of solid tumours with bone metastases requiring bone-targeting agents - part 1: an overview Including dental professionals in the multidisciplinary treatment team of head and neck cancer patients improves long-term oral health status Poor dental condition is a factor of imbalance of the nutritional status at the outset of management of head and neck cancer
  • Research
  • Published:
  • Vinod Patel1,
  • Dipesh Patel2,
  • Timothy Browning3,
  • Sheelen Patel3,
  • Mark McGurk4,
  • Isabel Sassoon5,
  • Teresa Guerrero Urbano6 &
  • …
  • Michael Fenlon7

British Dental Journal volume228,pages 435–440 (2020)Cite this article

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Abstract

Objectives Dental assessment remains a key intervention for head and neck cancer (HNC) patients pre-radiotherapy (RT). The purpose of this study was to identify the variation in dental status of patients pre-treatment, with respect to population and oncological demographics.

Materials and methods The study reviewed dental panoramic radiographs of HNC patients seen on a dedicated pre-RT dental clinic from 2011-2017. Only patients who had undergone intensity-modulated radiotherapy treatment were included within this study. Relevant dental and oncological data were collected.

Results A total of 886 patients were included in this study, with oropharyngeal cancer constituting 36% of the cohort. The average number of teeth in HNC patients was <21 at the pre-RT phase, which is below the recognised threshold for a functional dentition. Smoking status has a significant impact on overall DMFT (decay/missing/filled teeth), severity of horizontal bone loss and the number of third molars present (p <0.001). In the latter, males had a higher mean number of third molars compared to females (p <0.005). Comparing dental status of patients based on their tumour sub-site identified significant (p <0.0005) variation in all aforementioned categories.

Conclusion There are distinct differences in the dental health of HNC patients due to commence RT, compared to the general population. It varies by cancer sub-site and this should be taken into consideration at dental assessment to tailor a dental care plan to the needs of the individual. Consideration should be given to balancing masticatory function against the risks of osteoradionecrosis on the background of increasingly extended survivorship.

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Presenting pre-radiotherapy dental status of head and neck cancer patients in the novel radiation era (3)

An audit into the timing of dental extractions pre-head and neck radiotherapy and the prevalence of osteoradionecrosis

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Authors and Affiliations

  1. Consultant, Oral Surgery Dept, Fl23, Tower Wing, Great Maze Pond, London Bridge, London, SE1 9RT, UK

    Vinod Patel

    See Also
    The dental management of patients irradiated for head and neck cancer

  2. Speciality Dentist, Oral Surgery Dept, Fl23, Tower Wing, Great Maze Pond, London Bridge, London, SE1 9RT, UK

    Dipesh Patel

  3. DCT, Oral Surgery Dep, Fl23, Tower Wing, Great Maze Pond, London Bridge, London, SE1 9RT, UK

    Timothy Browning&Sheelen Patel

  4. Professor/Consultant (Oral & Maxillofacial Surgeon), Head & Neck Centre, UCL Division of SurgicalInterventional Sciences, Head and Neck Unit, 250 Euston Road, London, NW1 2PG, UK

    Mark McGurk

  5. Statistician, Department of Informatics, 5.03, Bush House, Strand Campus, Kings College London, 44–46 Aldwych, Holborn, London, WC2B 4LL, UK

    Isabel Sassoon

  6. Consultant, Department of Oncology, Guy’s & St Thomas’ NHS Foundation Trust, SE1 9RT, UK

    Teresa Guerrero Urbano

  7. Professor of Prosthodontics/Honorary Consultant (Restorative Dentistry), Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, Floor 22, Guy’s Hospital, London, SE1 9RT, UK

    Michael Fenlon

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  1. Vinod Patel

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  2. Dipesh Patel

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  3. Timothy Browning

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  4. Sheelen Patel

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Correspondence to Vinod Patel.

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19/EE/0224 - dental status, radiotherapy doses and subsequent implications in head and neck cancer patients - a retrospective cohort study.

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Presenting pre-radiotherapy dental status of head and neck cancer patients in the novel radiation era (4)

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Patel, V., Patel, D., Browning, T. et al. Presenting pre-radiotherapy dental status of head and neck cancer patients in the novel radiation era. Br Dent J 228, 435–440 (2020). https://doi.org/10.1038/s41415-020-1327-y

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Presenting pre-radiotherapy dental status of head and neck cancer patients in the novel radiation era (2024)
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