THE DENTAL PROBLEMS OF PATIENTS WITH HEAD AND NECK-CANCER TREATED WITH CHART

Between 1985 and 1990, 99 head and neck cancer patients were treated a t Mount Vernon Centre for Cancer Treatment in a CHART pilot study. The aims of this retrospective review were to obtain baseline data for th is population on their pretreatment dental status and to determine the extent to which our conservative policy of teeth preservation is-bein g realised. This is of particular interest because of the believed spa ring of late normal tissue effects by CHART compared with conventional fractionation. Frier to treatment, 40% of patients were edentulous, a nd prophylactic dental clearance was avoided in 59% of the remaining ( dentate) patients. Following radiotherapy, only 21% of dentate patient s subsequently lost all their remaining teeth. The proportion of patie nts with full or partial upper dentures increased from 61% pretreatmen t to 76% post-treatment; the corresponding increase in lower dentures was 46% to 66%. However, actual usage of dentures decreased somewhat. There was only one documented case of (minor) osteo-radionecrosis of t he mandible which resolved with conservative care. The greater use in our patients of prophylactic measures, in particular, chlorhexidine an d fluoride mouthwashes seemed indicated. Copyright (C) 1996 Elsevier S cience Ltd