Abstract
Aims: The aim of this study was to investigate the approaches taken for dental assessment of patients with head and neck cancer (HNCa) by hospital dentists in New Zealand and Malaysia, in order to assist with the development of contemporary uniform guidelines for pre-radiation oral health management.
Methods: A review of national guidelines was conducted from United Kingdom, United States, Australia, and New Zealand. A questionnaire-based survey of specialists and hospital dentists working in a hospital setting within New Zealand and Malaysia was undertaken. Information was collected about knowledge of the effects of radiotherapy on the oral environment, current practice regarding the dental management of HNCa patients prior to radiotherapy, guidelines practitioners were currently using and problems that they faced treating HNCa patients.
Results: One hundred questionnaires were distributed; 50 for each country and the response rate was 75%. The respondents were consultants/specialist (34.7%), specialist registrars (8.0%), general dentists/ dental officers (38.7%), house surgeons/ first year dental officers (17.3%) and other (1.3%). The majority of respondents stated that multidisciplinary meetings (MDM) were held at their centre (New Zealand- 51.4%; Malaysia - 52.5%) but the health practitioners attending the MDM varied. Only 48.6% New Zealand and 2.5% Malaysian respondents followed formal guidelines or protocols for dental assessment of HNCa patients. Problems that were highlighted included late referral from the medical team, lack of radiation information and inadequate knowledge among the dentists themselves in managing these patients.
Conclusion: This study highlights the need for developing clinical guidelines to support effective dental treatment and management strategies for this vulnerable population. Effective communication between health professionals and improved training could enhance patient outcomes.