Who is Caring for Head and Neck Radiation Therapy Patients?

Background: Head and neck radiotherapy (HNRT) can destroy salivary glands which can result in radiation caries and/or complete destruction of the dentition. Proper fluoride (FL) use will prevent this complication. Objective: The purpose of this study was to determine general dentists' and radiation oncologists' knowledge and practice patterns for the use of FL in HNRT patients. The results of this study can be used to demonstrate the need for further education in caring for cancer patients to reduce post-radiation complications. Methods: Surveys were randomly mailed to 750 general dentists in the American Dental Association and 750 radiation oncologists in the American Society for Therpeutic Radiology and Oncology. The surveys contained questions concerning topics such as the extent of head and neck cancer training and knowledge level pertaining to proper FL use: whether FL use is appropriate at various radiation doses, type of FL recommended, method of FL application, and patient compliance with FL. Results: There were 116 (15%) general dentists and 117 (15%) radiation oncologists responding to the survey. Seven questions concerned proper FL usage; 8.04% (n=9) of general dentists and 5.22% (n=6) answered all seven correctly. One out of five respondents were unaware of their patients' compliance with FL, inferring that they were not following HNRT patients in this regard. The majority of general dentists, 78.5% (n=91), thought that their head and neck training was inadequate, compared to 21.5% (n=25) of radiation oncologists. Conclusion: This survey's results indicate that general dentists' and radiation oncologists' knowledge about proper FL use may not be sufficient, thereby placing patients' oral health in jeapardy. Education to increase knowledge in this area is imperative to improve the quality of life of HNRT patients. This research was supported by a UFCD Student Summer Research Fellowship and The Andrew J. Semesco Foundation.