A national survey of consultants, specialists and specialist registrars in restorative dentistry for the assessment and treatment planning of oral cancer patients

Dewan, Karun; Kelly, Robert D.; Bardsley, P F

doi:10.1038/sj.bdj.2014.544

Cited by 14 publications

(13 citation statements)

References 42 publications

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“…Besides technical and patient factors, treatment planning is also influenced by clinical experience, operator-related factors (4), as well the available sources of information (9)(10)(11)(12)(13)(14)(15). This complexity is the main reason behind the great variations observed in the restorative treatments that clinicians could recommend for a case (75)(76)(77). EBD could help address this problem.…”

Section: Student Opinions On Restorative Treatment Planningmentioning

confidence: 99%

Evidence‐based dentistry for planning restorative treatments: barriers and potential solutions

Afrashtehfar

Eimar

Yassine

et al. 2016

Eur J Dental Education

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Section: Student Opinions On Restorative Treatment Planningmentioning

confidence: 99%

Evidence‐based dentistry for planning restorative treatments: barriers and potential solutions

Afrashtehfar

Eimar

Yassine

et al. 2016

Eur J Dental Education

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“… 1 This should render patients dentally fit before treatment and ensure the oral cavity can be maintained and rehabilitated after treatment. 2 …”

Section: Oral and Dental Assessment Prior To Primary Treatmentmentioning

confidence: 99%

“…Planning for extraction of teeth which are of doubtful prognosis or are at risk of dental disease in the future and are in an area where there would be risk of osteoradionecrosis. 2 Extractions to be carried out as early as possible in the patient journey but, as a minimum, at least 10 days prior to radiotherapy…”

Section: Oral and Dental Assessment Prior To Primary Treatmentmentioning

confidence: 99%

“…Patients whose oral cavity, teeth, salivary glands and jaws will be affected should have assessment and appropriate management as early as possible to allow time for any necessary dental treatment 1 . This should render patients dentally fit before treatment and ensure the oral cavity can be maintained and rehabilitated after treatment 2 …”

Section: Oral and Dental Assessment Prior To Primary Treatmentmentioning

confidence: 99%

“…The aims of pre-treatment assessment are: Avoidance of unscheduled interruptions to primary treatment as a result of dental problems Pre-prosthetic planning and treatment, e.g. planning for primary implants and/or impressions for obturator Planning for extraction of teeth which are of doubtful prognosis or are at risk of dental disease in the future and are in an area where there would be risk of osteoradionecrosis 2 . Extractions to be carried out as early as possible in the patient journey but, as a minimum, at least 10 days prior to radiotherapy Planning for restoration of remaining teeth as required Preventive advice and treatment Assess potential for post-treatment access difficulties, e.g.…”

Section: Oral and Dental Assessment Prior To Primary Treatmentmentioning

confidence: 99%

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Restorative dentistry and oral rehabilitation: United Kingdom National Multidisciplinary Guidelines

Butterworth¹,

McCaul

Barclay

2016

J. Laryngol. Otol.

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This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK and provides recommendations on the pre-treatment oral and dental assessment, during and after treatment and oral rehabilitation. Restorative dentists are core members of the multidisciplinary team treating head and neck cancer patients, involved from the treatment planning phase through to long-term rehabilitation.Recommendations• Preventative oral care must be delivered to patients whose cancer treatment will affect the oral cavity, jaws, salivary glands and oral accessibility. (G)• Close working and communication between the surgeons, oncologists and restorative dental specialists is important in ensuring optimal oral health outcomes. (G)• Intensity-modulated radiotherapy has been shown to reduce long-term xerostomia and should be offered to all appropriate patients. (R)• If patients are deemed at risk of trismus they should be warned and its progressive and potentially irreversible nature explained. (G)• Where it is known that adjuvant radiotherapy will be given, extractions should take place at primary surgery to maximise the time for healing and minimise the number of surgical events for patients. (G)• Osseointegrated implants should be considered for all patients having resection for head and neck cancer. (G)

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Pre-radiotherapy dental extractions in patients with head and neck cancer: a Delphi study

Moore

McLister

O’Neill

et al. 2020

Journal of Dentistry

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Pre-radiotherapy dental extractions in patients with head and neck cancer: a Delphi study. ObjectivesTo gain a consensus from consultants in restorative dentistry about the types of teeth that should be extracted from head and neck cancer patients (HNC) pre-radiotherapy. MaterialsLiterature-and clinician-informed questionnaires were emailed to an 'expert panel' of consultants (n=24/28; 86%) in the United Kingdom (UK) and Ireland on three consecutive occasions (Delphi rounds). The results of Round 1 were used to revise the questionnaire that was distributed in Round 2, and this procedure was repeated for Round 3. During Rounds 2 and 3, participants were asked to indicate, on a 5-point Likert scale, their level of agreement with a series of statements on the types of teeth that should be extracted pre-radiotherapy. The target level of consensus for each statement was 70%. ResultsIn Round 2, there was consensus-agreement for 69 of 102 statements (i.e. 70% of participants rated 'agree' or 'strongly agree' to the relevant statement). Consensus agreement was also achieved for 20 of 28 statements in Round 3. Therefore, a total of 89 consensus statements are presented that illuminate the decision-making process for the pre-radiotherapy extraction of molar, premolar, and anterior teeth with periodontal pocketing, furcation disease, mobility, caries, tooth-wear, apical disease, or other pathology. ConclusionThe statements represent the consensus professional views of participated consultants in restorative dentistry in the UK and Ireland regarding the types of teeth that should be extracted from HNC patients pre-radiotherapy. The results provide a platform for the development of future guidelines. Clinical SignificancePre-radiotherapy dental assessments for head and neck cancer patients are considered mandatory. This study presents different criteria that should be considered for the treatment planning of these patients in relation to pre-radiotherapy extractions, according to the collective consensus opinion of participated consultants in restorative dentistry in the UK and Ireland. Highlights This Delphi study collated 'expert' opinion regarding pre-radiotherapy dental extractions. Consensus statements outline the types of teeth that should be extracted preradiotherapy. It is envisaged that the study's results will help to inform the development of new guidelines. Keywords Head and neck neoplasms Radiotherapy Dental caries Periodontal disease Tooth extraction Oral health Abbreviations BSSPD -British Society of Prosthodontics HNC -head and neck cancer IMRT -intensity modulated radiotherapy IQR -interquartile range M -median ORN -osteoradionecrosis P -percentage agreement QoL -quality of life QUB -Queen's University Belfast S -standard deviation UK -United Kingdom X -mean

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A national survey of consultants, specialists and specialist registrars in restorative dentistry for the assessment and treatment planning of oral cancer patients

Abstract: This study highlights the variability in the approach of clinicians in dental and oral rehabilitation of patients undergoing radiotherapy treatment for oral cancer patients.

Cited by 14 publications

References 42 publications

Evidence‐based dentistry for planning restorative treatments: barriers and potential solutions

Evidence‐based dentistry for planning restorative treatments: barriers and potential solutions

Restorative dentistry and oral rehabilitation: United Kingdom National Multidisciplinary Guidelines

Pre-radiotherapy dental extractions in patients with head and neck cancer: a Delphi study

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