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      Dental Disease Prior to Radiotherapy in Head and Neck Cancer Patients: Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad)

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          Abstract

          Background

          No evidence-based guidelines exist for preventive dental care before radiation therapy (RT) in head and neck cancer (HNC) patients. An ongoing multicenter, prospective cohort study, Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad) (1U01DE022939-01), is addressing this knowledge gap. The present manuscript evaluates the level of pre-RT dental disease in the OraRad cohort, factors associated with dental disease, and dental treatment recommendations made pre-RT.

          Methods

          As part of OraRad, caries, periodontal disease, dental recommendations, and dental interventions performed pre-RT were assessed.

          Results

          Baseline measures are reported for 356 participants (77% male) with mean (SD) age 59.9 (11.0) years. Measures included mean number of teeth (22.9), participants with at least one tooth with caries (37.2%), and participants with at least 1 tooth with probing depth ≥5 mm (47.4%). Factors associated with less extensive pre-RT dental disease included having at least a high school diploma, having dental insurance, history of routine dental care, and a smaller tumor size (T1 or T2). Based on the pre-RT dental examination, 163 (49.5%) participants had dental treatment recommended before RT, with extractions recommended most frequently.

          Conclusion

          Many HNC patients require dental treatment pre-RT; over one-third require extractions.

          Practical Implications

          Most HNC patients have some level of dental disease at the start of RT, indicating the importance of pre-RT dental evaluation. By observing dental outcomes post-RT, OraRad has the potential to determine best dental treatment recommendations for HNC patients.

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          Author and article information

          Journal
          7503060
          4439
          J Am Dent Assoc
          J Am Dent Assoc
          Journal of the American Dental Association (1939)
          0002-8177
          1943-4723
          2 October 2017
          December 2017
          01 December 2018
          : 148
          : 12
          : 868-877
          Affiliations
          [1 ]Department of Oral Medicine, Carolinas Medical Center, 1000 Blythe Blvd., Charlotte, NC 28203, USA
          [2 ]Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital, 1620 Tremont Street, 3 rd Floor, Boston, MA 02120, USA. Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
          [3 ]Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA. Division of Oral Medicine, University of Pennsylvania Health System, 3400 Civic Center Blvd, Philadelphia, PA 19104, USA
          [4 ]Department of Oral & Maxillofacial Surgery and Bluestone Center for Clinical Research, New York University College of Dentistry, 421 First Avenue, New York, New York 10010, USA
          [5 ]Department of Dental Ecology, School of Dentistry, University of North Carolina, CB 7450, Chapel Hill, NC, USA
          [6 ]Division of Biostatistics, School of Public Health, University of Minnesota, 2221 University Ave SE Suite 200, Minneapolis, MN 55414, USA
          [7 ]Section of Oral Medicine, MC1605, University of Connecticut Health, 263 Farmington Avenue, Farmington, CT 06030-1605, USA
          Author notes
          Corresponding Author: Dr. Michael Brennan, Department of Oral Medicine, Carolinas Medical Center, 1000 Blythe Blvd., Charlotte, NC 28203, USA., Phone: 704-355-4197, Fax: 703-355-5301, Mike.Brennan@ 123456carolinas.org
          Article
          PMC5777182 PMC5777182 5777182 nihpa906381
          10.1016/j.adaj.2017.09.011
          5777182
          29173331
          aca61ed5-7af9-42f0-a345-a14e63ed3515
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