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Restorative dentistry and oral rehabilitation: United Kingdom National Multidisciplinary Guidelines

  • C Butterworth (a1), L McCaul (a2) and C Barclay (a3)
Abstract
Abstract

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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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Address for correspondence: Chris Butterworth, Merseyside Regional Head and Neck Cancer Centre, University Hospital Aintree & Liverpool University Dental Hospital, Liverpool, UK E-mail: c.butterworth@liverpool.ac.uk
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1 MJ Shaw , ND Kumar , M Duggal , J Fiske , DA Lewis , T Kinsella Oral management of patients following oncology treatment: literature review. Br J Oral Maxillofac Surg 2000;38:519–24

2 K Dewan , RD Kelly , P Bardsley . A national survey of consultants, specialists and specialist registrars in restorative dentistry for the assessment and treatment planning of oral cancer patients. Br Dent J 2014;216:E27

3 AR Silva , FA Alves , SB Berger , M Giannini , MF Goes , MA Lopes . Radiation-related caries and early restoration failure in head and neck cancer patients. A polarized light microscopy and scanning electron microscopy study. Support Care Cancer 2010;18:83–7

4 AM Kielbassa , W Hinkelbein , E Hellwig , H Meyer-Luckel . Radiation-related damage to dentition. Lancet Oncol 2006;7:326–35

7 A Papas , D Russell , M Singh , R Kent , C Triol , A Winston . Caries clinical trial of a remineralising toothpaste in radiation patients. Gerodontology 2008;25:7688

10 E Schiegnitz , B Al-Nawas , PW Kammerer KA Grotz . Oral rehabilitation with dental implants in irradiated patients: a meta-analysis on implant survival. Clin Oral Investig 2014;18:687–98

11 A Korfage , GM Raghoebar , JJ Slater , JL Roodenburg , MJ Witjes , A Vissink Overdentures on primary mandibular implants in patients with oral cancer: a follow-up study over 14 years. Br J Oral Maxillofac Surg 2014;52:798805

13 MR Fenlon , A Lyons , S Farrell , K Bavisha , A Banerjee , RM Palmer . Factors affecting survival and usefulness of implants placed in vascularized free composite grafts used in post-head and neck cancer reconstruction. Clin Implant Dent Relat Res 2012;14:266–72

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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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