Oral and dental management for head and neck cancer patients treated by chemotherapy and radiotherapy

Cancers of the head and neck include those of the oral cavity, oropharynx, salivary glands, sinuses, nasopharynx, hypopharynx and larynx. There are approximately 6,700 new head and neck cancers diagnosed each year in England and Wales and approximately 1,100 in Scotland. Eighty-five percent of cases are in people aged over 50 years, however, there is evidence of increasing incidence in younger people.1^,2^,3 There has been a more than 30% increase in oral cavity cancer between 1990 and 2006 and the incidence of oropharyngeal cancer has more than doubled.1 There may be a change in the pattern of aetiology of oropharyngeal cancer, with human papilloma virus (HPV) rather than smoking and alcohol being the primary risk factor in a younger sub-population. Ninety percent of patients presenting with head and neck cancer have pre-existing dental disease. Many also have co-morbidities. These factors, together with the increasing retention of teeth into old age, result in significant challenges in the management of the oral and dental health for these patients.