Preradiation dental extraction decisions in patients with head and neck cancer

Objective. The first objectives of this international survey were to study how dental-related and radiotherapy-related risk factors influence clinicia ns preradiation dental decision making in patients with head and neck cance r and to evaluate clinicians' degree of certainty in making such decisions. A further objective was to examine the correlation of clinicians' policies with a policy based on a model for dental decision support that was presen ted in an earlier article. Study design. A consensus questionnaire was mailed to 54 oral-maxillofacial surgeons and hospital-based dentists at a number of international location s. The responses were aggregated and anonymously analyzed through use of a multiple regression procedure. Results. Forty-four clinicians returned the questionnaire (response rate, 8 1%). Nine clinicians (20%) were using printed clinical guidelines for prera diation dental screening. Eighty-eight percent of clinicians' preradiation decisions and 49% of their certainty could be explained by the studied risk factors. Not all risk factors were significant at P <.001. Clinicians' pol icies showed high correlation (.85) with the policy based on the model for dental decision support. Conclusions. The findings support our previous assumption that policies in this field seem to be based primarily on clinical experience and opinions r ather than on evidence-based clinical guidelines. We conclude that the clin ical usefulness and validity of the model for dental decision support shoul d now be tested and that it could also serve as a training tool.