The association between dental arch length and oral health-related quality of life in head and neck cancer patients post-radiotherapy.

AIMS: To assess the association between length of dental arch and oral health-related quality of life in head and neck cancer patients post-radiotherapy. METHODS: Thirty head and neck cancer participants reported their oral health-related quality of life using the oral health impact profile-14 instrument and their global self-rating of general and oral health. All patients had received chemotherapy and radiotherapy. The length of dental arch was assessed in three tooth relational categories: canine-to-canine, shortened (premolars to premolars), and long (molars to molars) dental arches. Inclusion of participants for any of the three categories required verification of opposing teeth relationship with Shim Stock paper. RESULTS: Out of 30 head and neck cancer patients, eight (27%) had a canine-to-canine dental arch, 14 (46%) had a shortened dental arch, and eight (27%) had a long dental arch. The median oral health impact profile-14 scores for participants respectively with the canine-to-canine dental arch was six (IQR = 9.25), seven (IQR = 8) for participants with shortened dental arch, and 11 (IQR = 12.5) for participants with long dental arch. There were no significant differences in oral health impact profile-14 scores between the three-tooth relational groups (Kruskal-Wallis H = 0.769, df = 2, P-value = .681). Similarly, there were no significant differences between three-tooth relational groups on the self rating of general (Chi-squared = 1.714, df = 2, P-value = .424) and oral health (Chi-squared = 1.393, df = 2, P-value = .498). CONCLUSION: Within the limitations of this study, no association was found between the length of dental arch and oral health-related quality of life in head and neck cancer patients post-radiotherapy. Other factors such as dry mouth, oral mucositis, loss of taste, and trismus should be considered as contributory factors to reduced oral health-related quality of life in head and neck cancer patients post-radiotherapy, particularly in relation to eating difficulties.

Patients with head and neck cancers' oral health knowledge, oral health-related quality of life, oral health status, and adherence to advice on discharge to primary dental care: A prospective observational study.

AIMS: This prospective observational study set out to assess patients' oral health knowledge, oral health related quality of life (OHRQoL) and status immediately posttherapy, and adherence with oral health behaviors posttreatment with radiotherapy for head and neck cancer (HaNC). METHODS: A prospective observational study post HaNC therapy. At time one (T1), prior to discharge to primary dental care, oral health knowledge, OHRQoL, and status were assessed and dental health advice was delivered. At time two (T2), four weeks postdischarge, patients' adherence with dental health advice was reassessed. RESULTS: Thirty people postradiotherapy were recruited (mean age 58.9, SD ± 8.4). Twenty-three (77%) were men. Thirteen (45%) respondents reported they were not informed about the side effects of radiotherapy. On discharge to primary care, 20 (67%) of the respondents rated their oral health as fair or worse, while 47% were displeased with dental appearance. Respondents reported a mean of 8.6 impacts (SD ± 5.3) on OHRQoL. Five (17%) and two (7%) patients had an established or a new osteoradionecrosis, respectively, and 16 patients (53%) had greater than two new carious teeth. One month postdischarge (T2), adherence with dental advice was high, 93% were registered with a primary care dentist and all brushed their teeth daily. CONCLUSION: Within the limitations of this study in a single-center, adherence with oral health advice was high. However, participants felt they received little preparatory information about side effects and impacts of radiotherapy on oral and dental health, and how to maintain oral health after radiotherapy.

Osteoradionecrosis following treatment for head and neck cancer and the effect of radiotherapy dosimetry: the Guy's and St Thomas' Head and Neck Cancer Unit experience.

OBJECTIVES: To analyze clinical features, dosimetric parameters, and outcomes of osteoradionecrosis (ORN). STUDY DESIGN: Thirty-six patients with ORN who had been previously treated with radiotherapy (RT) were retrospectively identified between January 2009 and April 2014. ORN volumes were contoured on planning computed tomography (CT) scans. Near maximum dose (D2%), minimum dose (Dmin), mean dose (Dmean), and percentage of bone volume receiving 50 Gy (V50) were examined. Clinical and dosimetric variables were considered to compare ORN resolution versus ORN persistence. RESULTS: Median interval time from end of RT to development of ORN was 6 months. Of the ORN cases, 61% were located in the mandible. Dmean to affected bone was 57.6 Gy, and 44% had a D2% 65 Gy or greater. Smoking was associated with ORN persistence on univariate analysis, but no factors were found to impact ORN resolution or progression on logistic regression. CONCLUSIONS: Prevention strategies for ORN development should be prioritized. Dose-volume parameters could have a role in preventing ORN.