Oral prehabilitation for patients with head and neck cancer: getting it right - the Restorative Dentistry-UK consensus on a multidisciplinary approach to oral and dental assessment and planning prior to cancer treatment

• Published in: British dental journal 2022-11, Vol.233 (9), p.794-800
• Main Authors: McCaul, Lorna K., Barclay, Stewart, Nixon, Peter, Yule, Pamela L., Trainor, Jenna, Stevenson, Brian, Paterson, Andrew, Nicol, Ailsa, Keys, Will, Donachie, Martin, Barker, Dean, Rollings, Sam, Killough, Simon, Ban, James, Chatzipantelis, Andreas, Gaitonde, Pallavi, Ranka, Meena, Ali, Zaid, MacInnes, Andrew, Taylor, Carly, Gopakumar, Ashish, Sharma, Praveen, Harper, Victoria, Rasaratnam, Lakshmi, Toor, Ishpinder, Rodriguez, Jose M.
• Format: Article
• Language: English
• Subjects: Cancer therapies; Collaboration; Dental care; Dentistry; Head & neck cancer; Patients; Rehabilitation
• ISSN: 0007-0610; 1476-5373
• DOI: 10.1038/s41415-022-5197-3

Historically, oral and dental issues for head and neck cancer patients were often not considered until after cancer treatment was complete. As a result, outcomes for oral rehabilitation were sometimes suboptimal. Inconsistencies in service delivery models and qualification, training and experience of staff delivering dental care often compounded this problem, making research and audit almost impossible. Collaborative working by consultants in restorative dentistry from all over the UK as part of a Restorative Dentistry-UK (RD UK) subgroup, renamed more recently as the RD-UK Head and Neck Cancer Clinical Excellence Network (CEN), has re-emphasised the importance of specialist restorative dentistry intervention at the outset of the head and neck cancer pathway to optimise outcomes of patient care. The CEN has driven several initiatives, reflecting Getting It Right First Time (GIRFT) principles aimed at reducing unwarranted variation. This improved consistency in approach and optimised collaborative working of the team now presents a better environment for multicentre audit and research. Ultimately, this should result in a continued improvement in patient and carer experience. Key points Optimal management of oral and dental care in the pre-treatment phase of the head and neck cancer pathway is key to producing the best possible outcomes for patients. Restorative dentistry consultants are core members of the head and neck cancer multidisciplinary team. The development of the Restorative Dentistry-UK Head and Neck Cancer Clinical Excellence Network has facilitated the standardisation of evidence-based pathways and models of care. It also provides support for all restorative dentistry consultants working in head and neck cancer, particularly those working single-handedly in district general hospitals.