Multidisciplinary care of the oral cancer patient, including the role of the general dental practitioner, in maintaining the patient’s oral health post radiotherapy.
Every year in Ireland over 400 people are diagnosed with head and neck cancer. Oral cancer, a specific type of head and neck cancer, is usually treated with surgery and often requires radiotherapy (RT). However, side effects of RT treatment, which include mucositis, xerostomia, radiation caries, trismus and osteoradionecrosis, can seriously compromise a patient’s quality of life. Treatment for oral cancer patients is managed in a multi-disciplinary team. General dental practitioners (GDPs), consultant/specialist dentists and oral-maxillofacial surgeons play an important role in these patients’ care.
Recent advances in the delivery of RT have not only improved loco-regional control and survival rates, but have also reduced the incidence and severity of RT-associated side effects; however, no mode of RT delivery has successfully eliminated side effects. The role of dentists is essential in maintaining oral health and all patients should be dentally screened prior to commencing RT.
Recent reports have attempted to standardise the quality of care for the oral cancer patient and have highlighted the significance of the role of the GDP. Despite the advancements in RT delivery, the dental team is still faced with a number of challenges, including the high number of patients lost to follow-up dental care, lack of an effective treatment for xerostomia, poor patient compliance, and a lack of standardised guidelines and funding.
Addressing these challenges will involve increased communication between all members of the multidisciplinary team and increased involvement of the GDP, thereby ensuring that dental care continues to evolve concurrently with new methods of RT delivery.
Journal of the Irish Dental Association 2013; 59 (3): 137-146
BDentSc BA BE PhD1
BDS(Stat) MSc PhD FDS RCSI, FFD RCSI1
BDentSc MDS FDS FFD1
FRCS FDSRCS MA FTCD FFSEM(UK) FFD RCSI1,2
1. Dublin Dental University Hospital,
2. St James’s Hospital,
Address for correspondence:
Prof. Leo Stassen
Oral and Maxillofacial Dept
Dublin Dental University Hospital
T: 01-612 7200