Oral cancer incidence is rising, with both the consequences of the disease and sequelae of treatment often having a significant impact on patient oral health and functionality. As a result, the restorative dentist has a key and varied role within the head and neck multidisciplinary team, from dental pre-assessments to complex oral rehabilitations following extensive surgical management. Radiotherapy is a key pillar of head and neck cancer treatment but also presents a particular set of issues for patients and their management by clinicians. Communication between all team members is vital to ensure optimal patient treatment, and ultimately led to the development of two novel intraoral shield appliances for dentate and edentulous patients to help combat some of these undesirable side effects.
Update of head and neck cancer epidemiology and management.
Outlining the role of the consultant restorative dentist in managing head and neck cancer patients undergoing radiotherapy.
Discussion of a novel intraoral shield appliance design.
Subscribe to Journal
Get full journal access for 1 year
only $20.79 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Rent or Buy article
Get time limited or full article access on ReadCube.
All prices are NET prices.
Semple C J, Killough S A. Quality of life issues in head and neck cancer. Dent Update 2014; 41: 346-348, 351-353.
National Cancer Institute. Head and Neck cancer definition. Available at https://www.cancer.gov/publications/dictionaries/cancer-terms/def/head-and-neck-cancer (accessed April 2020).
Cancer research UK. Head and neck cancers statistics. 2020. Available online at https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/head-and-neck-cancers (accessed April 2020).
Testino G. The burden of cancer attributable to alcohol consumption. Maedica (Buchar) 2011; 6: 313-320.
Anonymous. Study protocol for the World Health Organization project to develop a Quality of Life assessment instrument (WHOQOL). Qual Life Res 1993; 2: 153-159.
Rogers S N, Semple C, Babb M, Humphris G. Quality of life considerations in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016; 130(S2): S49-S52.
Scottish Government. Beating cancer: ambition and action. 2016. Available online at https://www.gov.scot/publications/beating-cancer-ambition-action/ (accessed June 2020).
Butterworth C, McCaul L, Barclay C L. Restorative dentistry and oral rehabilitation: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016; 130(S2): S41-S44.
Araghi A S, Nasry H. The reconstructive oral cancer patient: what the general dental practitioner needs to know. Br Dent J 2019; 227: 689-692.
Nutting C M, Morden J P, Harrington K J et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol 2011; 12: 127-136.
National Cancer Institute. Radiotherapy definition. Available at https://www.cancer.gov/publications/dictionaries/cancer-terms/def/radiotherapy (accessed April 2020).
Kudchadker R J, Antolak J A, Morrison W H, Wong P F, Hogstrom K R. Utilization of custom electron bolus in head and neck radiotherapy. J Appl Clin Med Phys 2003; 4: 321-333.
Katsura K, Utsunomiya S, Abe E et al. A study on a dental device for the prevention of mucosal dose enhancement caused by backscatter radiation from dental alloy during external beam radiotherapy. J Radiat Res 2016; 57: 709-713.
Nicolatou-Galitis O, Sarri T, Bowen J et al. Systematic review of anti-inflammatory agents for the management of oral mucositis in cancer patients. Support Care Cancer 2013; 21: 3179-3189.
Lalla R V, Bowen J, Barasch A et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 2014; 120: 1453-1461.
Migliorati C, Hewson I, Lalla R V et al. Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Support Care Cancer 2013; 21: 333-341.
Yarom N, Ariyawardana A, Hovan A et al. Systematic review of natural agents for the management of oral mucositis in cancer patients. Support Care Cancer 2013; 21: 3209-3221.
Jensen S B, Pedersen A M L, Vissink A et al. A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life. Support Care Cancer 2010; 18: 1039-1060.
Bhide S A, Miah A B, Harrington K J, Newbold K L, Nutting C M. Radiation-induced xerostomia: pathophysiology, prevention and treatment. Clin Oncol (R Coll Radiol) 2009; 21: 737-744.
Hahnel S, Behr M, Handel G, Bürgers R. Saliva substitutes for the treatment of radiation-induced xerostomiaa review. Support Care Cancer 2009; 17: 1331-1343.
Wranicz P, Herlofson B B, Evensen J F, Kongsgaard U E. Prevention and treatment of trismus in head and neck cancer: A case report and a systematic review of the literature. Scand J Pain 2010; 1: 84-88.
Chua D T, Lo C, Yuen J, Foo Y C. A pilot study of pentoxifylline in the treatment of radiation-induced trismus. Am J Clin Oncol 2001; 24: 366-369.
Bensadoun R-J, Riesenbeck D, Lockhart P B et al. A systematic review of trismus induced by cancer therapies in head and neck cancer patients. Support Care Cancer 2010; 18: 1033-1038.
Delanian S, Chatel C, Porcher R, Depondt J, Lefaix J-L. Complete restoration of refractory mandibular osteoradionecrosis by prolonged treatment with a pentoxifyllinetocopherolclodronate combination (PENTOCLO): a phase II trial. Int J Radiat Oncol Biol Phys 2011; 80: 832-839.
Public Health England. Delivering better oral health: an evidence based toolkit for prevention (third edition). 2014. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/605266/Delivering_better_oral_health.pdf (accessed October 2020).
de Paula Caldas M, de Moraes Ramos-Perez F M, de Almeida S M, Haiter-Neto F. Comparative evaluation among different materials to replace soft tissue in oral radiology studies. J Appl Oral Sci 2010; 18: 264-267.
Cancer Research UK. Head and neck cancer incidence by age. 2020. Available online at https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/head-and-neck-cancers/incidence#heading-One (accessed April 2020).
RD-UK. Predicting and managing oral and dental complications of surgical and non-surgical treatment for head and neck cancer a clinical guideline. 2016. Available at https://www.restdent.org.uk/uploads/RD-UK%20H%20and%20N%20guideline.pdf (accessed October 2020).
About this article
Cite this article
Colloc, T., Brown, T. & Keys, W. Role of the consultant in restorative dentistry in managing head and neck cancer patients undergoing radiotherapy: a novel intraoral shield appliance design. Br Dent J 229, 655–660 (2020). https://doi.org/10.1038/s41415-020-2349-1