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

Abstract

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.

The positive impact of dental care on the patient's quality of life after cancer treatment: a case report

“…The QoL measurement was performed at different times, since the initial consultation; throughout DT, including periodontics, extraction, endodontics, and dentistry; at the end of DT; and in the follow-up of 1 year and 2 months post-DT. Barrios, Tsakos, García-Medina, Martínez-Lara and Bravo (2014) reported that the majority of head and neck cancer patients had five or more impacts on QoL and 97% with at least one impact, just like Abed et al (2019), with an average of eight per patient, including pain, social and functional impairment. Other studies (Barrios et al, 2015;Becker et al, 2012;Viet, Corby, Akinwande & Schmidt, 2014) also reported a negative physical impact on the health-related QoL of these patients.…”

“…For QoL research, there is no gold standard questionnaire, with a variety (Karimi et al, 2019) including OHIP-14 (Abed et al, 2019;Stuani et al, 2018), OHIP-49 (Fromm et al, 2019;Gotfredsen & Abdullah, 2015), questionnaires from the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 / QLQ-H / N35 (Karimi et al, 2019).…”

“…Post-cancer treatment patients may have late consequences manifested in the oral cavity and deficit in the defense of the organism, which can negatively impact the quality of life (QoL) (Abed, Reilly, Burke & Daly, 2019), especially in head and neck cancer.…”

“…The Oral Health Impact Profile (OHIP-14) questionnaire (Slade, 1997), through selfperception and psychometric qualities, assesses the impact of oral health on QoL (Allen, 2003;Locker, 1997). QoL in a patient after head and neck radiotherapy has the main impacts on pain, social, and functional impairments (Abed et al, 2019). Other tools to measure QoL in cancer patients, such as OHIP-49 (Fromm, Gotfredsen, Wessel & Ozhayat, 2019), University of Washington QoL Questionnaire (HNC-PCI) (Ghazali, Roe, Lowe & Rogers, 2015;Biazevic et al, 2010), EORTC QLQ -C30 and QLQ-H and N35 (Karimi et al, 2019) are also useful tools.…”

“…There is a limited understanding of the impact of radiotherapy on the state of oral health in the immediate post-radiotherapy period (Epstein, Robertson, Emerton, Phillips & Research, Society and Development, v. 9, n. 9, e650997639, 2020(CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.7639 Stevenson-Moore, 2001). The measurement of QoL after cancer treatment is performed at different times, from the first day after radiotherapy (RT), 3 months after RT (Kamiri et al, 2019), before adherence to dental care and 4 weeks after (Abed et al, 2019). Thus, assessing how the consequences of antineoplastic treatment affect the routine of these individuals has been the subject of study by researchers.…”