Advertisement

Evaluation of a community-based dental screening program prior to radiotherapy for head and neck cancer: a single-center experience

  • Elizabeth WaringEmail author
  • Hani Mawardi
  • Sook Bin Woo
  • Nathaniel Treister
  • Danielle N. Margalit
  • Jennifer Frustino
  • Alessandro Villa
Original Article
  • 34 Downloads

Abstract

Purpose

Oral toxicities following radiation therapy (RT) for head and neck (HN) cancer can be profound and are associated with poor health outcomes. The Division of Oral Medicine and Dentistry at Brigham and Women’s Hospital and Dana-Farber Cancer Institute therefore implemented a dental evaluation program designed for community-based (CB) dentists to evaluate and treat patients scheduled for HN RT. The aim of this retrospective single-center cohort study was to assess the compliance of CB dentists with this pre-RT dental evaluation program.

Methods

A retrospective analysis of dental evaluations completed by CB dentists from December 2013 to December 2015 was performed. Descriptive statistics were used to determine compliance.

Results

A total of 186 dental evaluations were received. Compliance with completion of dental treatment was as follows: scaling and prophylaxis: 94.5% (172/182); dental restorations: 78.7% (48/61); endodontic therapy: 76.9% (10/13); and dental extractions: 76.9% (30/39). Compliance of CB dentists with all requested components of the pre-RT evaluation and treatment was 77.4% (144/186). The median distance traveled by patients to the CB dentist and to the hospital was 5.2 miles (range 0.03–66.0) and 46.5 miles (range 0.8–1457; p < 0.01), respectively.

Conclusion

In this study, the majority of patients completed their necessary dental treatment in a timely manner by their CB dentist in collaboration with an oral medicine specialist. Given the high compliance of CB dentists, this program could serve as a model for other cancer centers to optimize oral and dental health prior to RT.

Keywords

Head and neck cancer Head and neck radiation Dental screening Caries Osteoradionecrosis 

Notes

Compliance with ethical standards

Conflict of interest

Dr. Margalit reports personal fees from Galera Therapeutics, outside the submitted work. The corresponding author is in full control of the primary data and gives permission to the journal to review if requested.

References

  1. 1.
    American Cancer Society. https://cancerstatisticscenter.cancer.org/ - !/. Accessed 2/16/18., in National Cancer Institute
  2. 2.
    Adelstein D, Gillison ML, Pfister DG, Spencer S, Adkins D, Brizel DM, Burtness B, Busse PM, Caudell JJ, Cmelak AJ, Colevas AD, Eisele DW, Fenton M, Foote RL, Gilbert J, Haddad RI, Hicks WL Jr, Hitchcock YJ, Jimeno A, Leizman D, Lydiatt WM, Maghami E, Mell LK, Mittal BB, Pinto HA, Ridge JA, Rocco J, Rodriguez CP, Shah JP, Weber RS, Witek M, Worden F, Yom SS, Zhen W, Burns JL, Darlow SD (2017) NCCN guidelines insights: head and neck cancers, version 2.2017. J Natl Compr Cancer Netw 15(6):761–770CrossRefGoogle Scholar
  3. 3.
    Ferris RL, Blumenschein G Jr, Fayette J, Guigay J, Colevas AD, Licitra L, Harrington K, Kasper S, Vokes EE, Even C, Worden F, Saba NF, Iglesias Docampo LC, Haddad R, Rordorf T, Kiyota N, Tahara M, Monga M, Lynch M, Geese WJ, Kopit J, Shaw JW, Gillison ML (2016) Nivolumab for recurrent squamous-cell carcinoma of the head and neck. N Engl J Med 375(19):1856–1867CrossRefGoogle Scholar
  4. 4.
    Brunner M, Gore SM, Read RL, Alexander A, Mehta A, Elliot M, Milross C, Boyer M, Clark JR (2015) Head and neck multidisciplinary team meetings: effect on patient management. Head Neck 37(7):1046–1050CrossRefGoogle Scholar
  5. 5.
    Friedland PL, Bozic B, Dewar J, Kuan R, Meyer C, Phillips M (2011) Impact of multidisciplinary team management in head and neck cancer patients. Br J Cancer 104(8):1246–1248CrossRefGoogle Scholar
  6. 6.
    Kelly SL, Jackson JE, Hickey BE, Szallasi FG, Bond CA (2013) Multidisciplinary clinic care improves adherence to best practice in head and neck cancer. Am J Otolaryngol 34(1):57–60CrossRefGoogle Scholar
  7. 7.
    Hong CH et al (2010) A systematic review of dental disease in patients undergoing cancer therapy. Support Care Cancer 18(8):1007–1021CrossRefGoogle Scholar
  8. 8.
    Jensen SB et al (2010) A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: management strategies and economic impact. Support Care Cancer 18(8):1061–1079CrossRefGoogle Scholar
  9. 9.
    Nadella KR, Kodali RM, Guttikonda LK, Jonnalagadda A (2015) Osteoradionecrosis of the jaws: clinico-therapeutic management: a literature review and update. J Maxillofac Oral Surg 14(4):891–901CrossRefGoogle Scholar
  10. 10.
    Margalit DN, Losi SM, Tishler RB, Schoenfeld JD, Ann Fugazzotto J, Stephens J, Cebulski AL, Hammerstrand EL, Ma L, Lopes HM, Haddad RI, Treister NS, Frustino JL (2015) Ensuring head and neck oncology patients receive recommended pretreatment dental evaluations. J Oncol Pract 11(2):151–154CrossRefGoogle Scholar
  11. 11.
    Lockhart PB, Clark J (1994) Pretherapy dental status of patients with malignant conditions of the head and neck. Oral Surg Oral Med Oral Pathol 77(3):236–241CrossRefGoogle Scholar
  12. 12.
    Jham BC, Reis PM, Miranda EL, Lopes RC, Carvalho AL, Scheper MA, Freire AR (2008) Oral health status of 207 head and neck cancer patients before, during and after radiotherapy. Clin Oral Investig 12(1):19–24CrossRefGoogle Scholar
  13. 13.
    Rosales AC et al (2009) Dental needs in Brazilian patients subjected to head and neck radiotherapy. Braz Dent J 20(1):74–77CrossRefGoogle Scholar
  14. 14.
    Brennan MT, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Mohammadi K, Long Simpson L, Voelker H, Hodges JS, Lalla RV (2017) Dental disease before radiotherapy in patients with head and neck cancer: Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients. J Am Dent Assoc 148(12):868–877CrossRefGoogle Scholar
  15. 15.
    Jones AP, Haynes R, Sauerzapf V, Crawford SM, Zhao H, Forman D (2008) Travel time to hospital and treatment for breast, colon, rectum, lung, ovary and prostate cancer. Eur J Cancer 44(7):992–999CrossRefGoogle Scholar
  16. 16.
    Lightfoot N, Steggles S, Gauthier-Frohlick D, Arbour-Gagnon R, Conlon M, Innes C, Bonsawin L, Merali H (2005) Psychological, physical, social, and economic impact of travelling great distances for cancer treatment. Curr Oncol 12(4):1–7Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Elizabeth Waring
    • 1
    Email author
  • Hani Mawardi
    • 2
  • Sook Bin Woo
    • 3
    • 4
    • 5
  • Nathaniel Treister
    • 3
    • 4
    • 5
  • Danielle N. Margalit
    • 6
  • Jennifer Frustino
    • 7
  • Alessandro Villa
    • 3
    • 4
    • 5
  1. 1.College of DentistryUniversity of Tennessee Health Science CenterMemphisUSA
  2. 2.Faculty of DentistryKing AbdulAziz UniversityJeddahSaudi Arabia
  3. 3.Division of Oral Medicine and DentistryBrigham and Women’s HospitalBostonUSA
  4. 4.Division of Oral Medicine and Dentistry, Brigham and Women’s HospitalDana-Farber Cancer InstituteBostonUSA
  5. 5.Department of Oral Medicine, Infection and ImmunityHarvard School of Dental MedicineBostonUSA
  6. 6.Department of Radiation OncologyDana-Farber Cancer Institute/Brigham & Women’s Cancer CenterBostonUSA
  7. 7.Division of Oral Oncology and Maxillofacial ProstheticsErie County Medical CenterBuffaloUSA

Personalised recommendations