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

Research output: Contribution to journalArticle

Vinod Patel, Dipesh Patel, Timothy Browning, Sheelen Patel, Mark McGurk, Isabel Sassoon, Teresa Guerrero Urbano, Michael Fenlon

Original languageEnglish
Pages (from-to)435-440
Number of pages6
JournalBritish Dental Journal
Volume228
Issue number6
DOIs
Publication statusPublished - 1 Mar 2020

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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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