Including dental professionals in the multidisciplinary treatment team of head and neck cancer patients improves long-term oral health status

Bertl, Kristina; Savvidis, Philippe; Kukla, Edmund Benjamin; Schneider, Steffen; Zauza, Konstantin; Bruckmann, Corinna; Stavropoulos, Andreas

doi:10.1007/s00784-021-04276-x

Cited by 14 publications

(12 citation statements)

References 42 publications

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“…There are only limited data at which rate required dental treatment recommendations are subsequently implemented. As Bertl et al reported that about 90% of patients followed dental recommendations involving a multidisciplinary treatment team, we may assume that in most of our patients' recommendations before radiotherapy we mostly adequately followed (Bertl et al, 2022 ).…”

Section: Discussionmentioning

confidence: 95%

Dental management before radiotherapy of the head and neck region: 4‐year single‐center experience

Hoffmann

Marschner

Kakoschke

et al. 2022

Clinical & Exp Dental Res

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Objective: To review our experience with a standardized dental management approach in patients with planned radiotherapy of the head and neck region based on preradiation and follow-up data.Material and Methods: Records of patients who underwent radiotherapy between June 2016 and November 2020 were reviewed. Data on dental findings and therapeutic recommendations were extracted from a prospectively managed database. Hospital records were used to obtain follow-up data.Results: Two hundred eighty-one patient records were identified. After the exclusion of 81 patients because of incomplete data, 200 patients were included in the study. Dental findings relevant to radiotherapy were found in 144 cases (72.0%). Teeth extractions were recommended in 112 (56.0%) patients. Follow-up data were available for 172 (86.0%) patients (mean follow-up: 16.8 ± 10.7 months).Radiodermatitis was the most frequently observed sequela of radiotherapy (42.4%), followed by dysphagia (38.4%) and stomatitis (36.6%). Osteoradionecrosis was observed in only 2.3% of the patients. Conclusion:Dental findings relevant to planned radiotherapy were frequent and in many cases resulted in recommendations for teeth extraction. Based on our standardized dental management protocol, we observed low rates of late oral complications after radiotherapy of the head and neck region.dental management, follow-up, oral cancer, radiotherapy | INTRODUCTIONRadiotherapy is a standard form of treatment for many head and neck tumors. Depending on the tumor entity, size, stage, localization, grade, resection status, and patient comorbidities, radiotherapy can be applied as an adjuvant or alternative to surgery. Where indicated, it can be combined with chemotherapy (Koga et al., 2008). Radiotherapy leads to a decreased proliferation rate or even apoptosis: the tumor stops growing or decays. Nevertheless, the cell-damaging effects of radiation therapy are nonspecific, and the tumorsurrounding tissue (i.e., oral mucosa, salivary glands, maxillary and mandibular bone, teeth, and masticatory muscles) is affected as well

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Section: Discussionmentioning

confidence: 95%

Dental management before radiotherapy of the head and neck region: 4‐year single‐center experience

Hoffmann

Marschner

Kakoschke

et al. 2022

Clinical & Exp Dental Res

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“…The inclusion of dental health in the MDT meeting can be a simple yet effective way of bringing the attention to oral care 39 . This may be as in‐depth as the inclusion of an oral health professional to perform a dental screening as part of a CF annual review, to something as simple as ticking a dental checkbox by asking the question, “have they been to see a dentist this year”?…”

Section: Discussionmentioning

confidence: 99%

“…The inclusion of dental health in the MDT meeting can be a simple yet effective way of bringing the attention to oral care. 39 This may be as in-depth as the inclusion of an oral health professional to perform a dental screening as part of a CF annual review, to something as simple as ticking a dental checkbox by asking the question, "have they been to see a dentist this year"? These reminders will give an opportunity for all health professionals and patients to think about dental health and may also provide better confidence in the MDT to discuss dental health and become more familiar with referral processes.…”

Section: Health Professionals' Views On Improving Cf Dental Carementioning

confidence: 99%

Oral health and cystic fibrosis in pediatrics: A survey of health professionals

Chin

Ramalingam

Harrison

et al. 2023

Pediatric Pulmonology

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Background: Children with cystic fibrosis (CF) are usually managed by hospitalbased, multidisciplinary teams (MDTs). This study aimed to investigate oral health perspectives, training, and practices of health professionals working with children with CF. Methods: Data were collected through an online survey distributed to health professionals caring for children with CF by the CF Director in 12 Australian hospitals. The questions related to perspectives, training, and dental referral/ advice relating to oral health for children with CF. The data were analyzed using descriptive statistics.Results: Forty-four participants (26 physicians, 8 nurses, 6 physiotherapists, 2 dieticians, 1 psychologist, and 1 pharmacist) completed the survey. Most (n = 33, 75%) indicated they rarely/never check or discuss dental health. Of those who did, most reported lacking skills to inspect teeth and discuss dental health. Frequently reported barriers were lack of skills, training, knowledge, and time. Most respondents (n = 30, 68%) indicated they rarely/never recommend patients to see the dentist. The most frequently reported barrier to referrals was not considering it part of their role (43%).Conclusions: Closer working relations between CF units and dental teams may remove barriers that prevent non-dental clinicians from supporting patients with CF maintain oral health. Better integration of dental care within the MDT through improved professional training, increased referral practices, and availability of digital resources may help to improve dental care for all children, including children and adolescents with CF.

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“…This model is commonly implemented in high-level oncology hospitals or oncology departments within large general hospitals [11]. It represents a leading international standardized diagnosis and treatment model [14][15][16][17]. The second form refers to multidisciplinary consultations organized by relevant departments according to the needs of patients or their families.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Clinicians' Cognition and Influencing Factors in Multidisciplinary Treatment Implementation: A Study in Municipal Public Class III Grade A Hospitals in Southwest China

Zhong,

Zeng,

Zhao

et al. 2023

Preprint

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Background Previous studies have highlighted many problems in the implementation of multidisciplinary treatment (MDT) from a managerial perspective. However, no study has addressed these issues from clinicians’ perspective. Therefore, this study aimed to identify and address the existing problems in MDT by investigating the clinicians' cognition of MDT, the influencing factors, and strategies to improve its quality. Methods A self-designed questionnaire was used to evaluate the cognition of MDT clinicians in municipal public Class III Grade A hospitals in Western China. Results Overall, 70.56% of clinicians knew the scope of MDT, and 63.41% knew the process of MDT. Professional title (P = 0.001; OR: 2.984; 95% CI: 1.590–5.603), participated in MDT (P = 0.017; OR: 1.748; 95% CI: 1.103–2.770), application for MDT (P = 0.000; OR: 2.442; 95% CI: 1.557–3.830) had an impact on clinicians' awareness of the scope of MDT. Professional title (P = 0.002; OR:2.446; 95% CI: 1.399–4.277), and participation in MDT (P = 0.000; OR: 2.414; 95% CI: 1.581–3.684) influenced clinicians' knowledge of the scope of MDT. Conclusion Approximately one-third of clinicians were not fully aware of the consultation process, whereas experienced doctors or those who had participated in MDT demonstrated a better understanding. The inadequate dissemination of MDT knowledge emphasizes the need for medical management departments to enhance MDT education, particularly for new and young doctors. Furthermore, MDT plays an important role in clinical care. Nevertheless, clinical medical personnel have not yet fully mastered the scope and process of MDT. As a result, many problems persist in its implementation that necessitate attention from the management department.

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Including dental professionals in the multidisciplinary treatment team of head and neck cancer patients improves long-term oral health status

Cited by 14 publications

References 42 publications

Dental management before radiotherapy of the head and neck region: 4‐year single‐center experience

Dental management before radiotherapy of the head and neck region: 4‐year single‐center experience

Oral health and cystic fibrosis in pediatrics: A survey of health professionals

Assessment of Clinicians' Cognition and Influencing Factors in Multidisciplinary Treatment Implementation: A Study in Municipal Public Class III Grade A Hospitals in Southwest China

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