Poor dental condition is a factor of imbalance of the nutritional status at the outset of management of head and neck cancer

Devoize, Laurent; Dumas, Camille; Lambert, Céline; Yagoubi, Mohamed El; Mom, T.; Farigon, N.; Gilain, L.; Boirie‌, Yves; Saroul, N.

doi:10.1007/s00784-021-04097-y

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…Thereby, uniform methods or widely accepted standardized protocols for dental status assessment are lacking. Despite the use of different study methods and dental status assessment methods, our results are in line with a study published in 2008 suggesting that dental condition, defined by the decayed, missing, and filled teeth index and the masticatory coefficient are risk factors for weight loss at the outset of management of head and neck cancer (HNC) [35]. Another study evaluated dental status by using the Eichner Index in a sample of 104 treatmentnaïve HNC patients [36].…”

Section: Discussionsupporting

confidence: 87%

Tooth extractions prior to chemoradiation or bioradiation are associated with weight loss during treatment for locally advanced oropharyngeal cancer

Buurman

Willemsen

Speksnijder

et al. 2022

Support Care Cancer

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Purpose Prior to radiotherapy combined with chemotherapy (CRT) or biotherapy (BRT) for oropharyngeal squamous cell carcinoma (OPSCC), teeth with poor prognosis that pose a risk for post-RT osteoradionecrosis (ORN) are removed. The effect of tooth loss on body weight loss and tube feeding (TF) dependency during CRT/BRT is unknown. This study aimed to evaluate the effect of incomplete dentition, tooth extractions prior to CRT/BRT, and the subsequent loss of functional units on (1) weight loss during CRT/BRT and (2) the need for TF during CRT/BRT for OPSCC. Methods OPSCC patients treated with CRT/BRT between 2013 and 2016 were included in this retrospective cohort study. Dental status was determined during the dental assessment at first visit and after tooth extractions prior to the start of CRT/BRT. Weight loss during CRT/BRT was scored dichotomously, comparing weight loss > 5% to stable or increased weight. Potential factors associated with weight loss were identified, including patient, tumor, and treatment characteristics. Results Seventy-seven OPSCC patients were included. Forty patients (52%) experienced weight loss > 5% during CRT/BRT. Extractions were performed in 66% of the OPSCC patients. The mean number of extracted teeth was 4.1 ± 5.6 per patient. Tooth extractions prior to CRT/BRT were associated with weight loss > 5% during CRT/BRT (HR 1.130 (95% CI 1.011–1.262), p = 0.031). None of the dental status-related parameters showed any significant associative value for TF during CRT/BRT. Conclusions Pre-CRT/BRT tooth extractions intended to reduce the risk of ORN, are a risk factor for weight loss during CRT/BRT for OPSCC. Trial registration number This study was approved by the medical ethics committee of the MUMC + (METC 2020–1589) on July 28, 2020.

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Section: Discussionsupporting

confidence: 87%

Tooth extractions prior to chemoradiation or bioradiation are associated with weight loss during treatment for locally advanced oropharyngeal cancer

Buurman

Willemsen

Speksnijder

et al. 2022

Support Care Cancer

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“…In contrast, neglecting professionally or personally administered oral care before and after completion of HNC treatment can lead to untreated radiation caries in up to 100% of the cases (Bhandari et al, 2021). This in turn may lead to unwanted side effects, such as, for example, increased weight loss (Devoize et al, 2022). However, despite that such important advantages in the management of HNC patients have been reported in the literature, implementation appears difficult in the various HNC hospitals/centers across the EU, as shown by the present survey.…”

Section: Discussionmentioning

confidence: 99%

A survey on oral health‐related standard of care for head and neck cancer patients in the EU

Bertl,

Kogelnik,

Kukla

et al. 2023

Oral Diseases

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ObjectiveTo map oral health‐related standard of care in the context of head and neck cancer (HNC) treatment across the European Union (EU).Materials and MethodsSix hundred and ninety centers across the European Union were contacted. The questionnaire contained questions focusing on the team/department structure, HNC treatment planning routines, and assessment and handling of dental treatment needs prior to cancer treatment.ResultsEighty‐seven centers across the EU responded. Department structure and number of HNC patients treated per year varied widely and dental professionals are included as part of the team in about 25% of the centers. Standard of care, in terms of dental assessment and preventive dentistry routines, such as recording an orthopantomogram, offering dental treatment, and providing a radiation protection splint and splint for fluoride application, differed significantly among the European regions. Independent of the region, these aspects are positively affected if dental professionals are part of the interdisciplinary treatment team and if dental treatment is offered within the center.ConclusionDental professionals are still only to a very limited extent included in interdisciplinary treatment planning teams of HNC patients. However, their inclusion and/or offering dental treatment within the same hospital/center appears to improve oral health‐related standard of care.Clinical RelevanceInclusion of dental professionals in treatment planning teams of HNC patients appears to improve oral health‐related standard of care within HNC treatment.

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“…Dental condition is a risk factor for weight loss in HNC at the outset. 44 Dietitians work alongside restorative dentists and the wider MDT to ensure nutritional needs are met while balancing the importance of oral hygiene and prevention of dental caries. 33 This is further explained by the risks outlined in Table 2 and strategies to mitigate these.…”

Section: Consideration Of Dental Care Alongside Nutritional Intervent...mentioning

confidence: 99%

Malnutrition, nutrition support and dietary intervention: the role of the dietitian supporting patients with head and neck cancer

2022

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Malnutrition is prevalent in patients with head and neck cancer (HNC) at diagnosis but can occur at any stage of the treatment pathway. The impact of disease burden and treatment side effects can lead to altered anatomy, compromised quality and quantity of saliva and impaired swallowing function, which can result in deleterious effects on nutritional status. Optimising nutrition status is critical, as malnutrition is adversely associated with treatment tolerance and outcomes, wound healing, morbidity, mortality, quality of life and survival. Dietitians are integral members of the HNC multidisciplinary team and are uniquely qualified in the assessment, management and optimisation of nutritional status across the care pathway. This includes providing informational counselling to patients and carers on the short- and long-term nutritional impact of planned treatments alongside multidisciplinary members. Dietitians lead on the recommendation, provision and monitoring of nutrition support, which can be via the oral, enteral or parenteral route. Oral nutrition support includes dietary counselling, nourishing dietary, food fortification advice and high energy/protein oral nutritional supplements. Enteral nutrition support, or tube feeding, can be required on a short- and/or long-term basis and dietitians support appropriate decision-making for the type of tube and timing of placement across the care pathway.

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Poor dental condition is a factor of imbalance of the nutritional status at the outset of management of head and neck cancer

Cited by 6 publications

References 33 publications

Tooth extractions prior to chemoradiation or bioradiation are associated with weight loss during treatment for locally advanced oropharyngeal cancer

Tooth extractions prior to chemoradiation or bioradiation are associated with weight loss during treatment for locally advanced oropharyngeal cancer

A survey on oral health‐related standard of care for head and neck cancer patients in the EU

Malnutrition, nutrition support and dietary intervention: the role of the dietitian supporting patients with head and neck cancer

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