Head and neck cancer part 3: dental management Stephanie Hackett Oliver Jones Despoina Chatzistavrianou David Newsum Dental Update 2024 46:11, 707-709.
Specialist in Prosthodontics, Specialty Registrar in Restorative Dentistry, Birmingham Dental Hospital and University of Birmingham School of Dentistry, Birmingham Community Healthcare NHS Trust, Birmingham, UK
Consultant in Restorative Dentistry, BDS, MFD RCS, MSc, MRCPS, MRD RCSEd, FDS(Rest Dent) RCSEd, Birmingham Dental Hospital and School of Dentistry, Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
This is the third and final paper in the series. Oral and dental complications of head and neck cancers, and the associated treatments, can be devastating to patients. General dental practitioners are likely to encounter affected patients at various points along their treatment journey, which may involve the management of treatment side-effects or facilitating the post-treatment rehabilitation. This paper will discuss accepted preventive regimens for patients, management of treatment side-effects and specific cases of restorative rehabilitation post-treatment, highlighting the levels of treatment that can usually be provided in primary and secondary care settings.
CPD/Clinical Relevance: This paper aims to provide the reader with knowledge and confidence to manage the dental needs of head and neck cancer patients and post-treatment side-effects.
Article
Head and neck cancer can result in significant short- and long-term complications which can affect function, aesthetics and social wellbeing. As discussed in the previous paper in this series, there are short- and long-term side-effects associated with surgery, radiotherapy and chemotherapy. Table 1 provides an overview of common side-effects and management techniques. Clinicians can utilize this advice to help relieve patients of oral mucositis, infections, trismus, xerostomia and caries.
General Dental Practitioners (GDPs) should be aware of the importance of effective preventive regimens for head and neck cancer patients in order to assist in the holistic management alongside secondary care teams. The side-effects of treatment can place patients at lifelong high risk of dental disease and they should be managed accordingly, with full guidance taken from Delivering Better Oral Health.7 An individualized preventive regimen should also be implemented with advice taken from the lead Restorative Dentist in the multidisciplinary team (MDT). Recall intervals should be reduced to 3–4 monthly in line with NICE recall guidance.10
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