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

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.