Oral Function Management of Head and Neck Cancer Patients in Our Department

Purpose: Dental intervention in conjunction with cancer treatment is suggested in cancer base hospitals such as cancer centers and university hospitals to prevent oral problems in cancer patients. Our department set up an oral care support team in July 2011, and has been working to reduce postoperative complications in head and neck cancer patients. The present paper reports the activities of the oral care support team. Methods: A retrospective observation study of the patients' background, number of intervention cases, complications, and dental treatment at intervention was performed in head and neck cancer patients referred from the otolaryngology department between July 1, 2011 and December 31, 2012. Results: The subjects were 102 head and neck cancer patients (81 males and 21 females) with an average age of 64.1 years. Primary diseases were 29 oral cancers, 24 oropharynx cancers, 8 larynx cancers, 6 primary unknown cancers, 5 nasopharyngeal cancers, 4 nasal cavity cancers, 4 salivary gland cancers, and 4 others. Half of these cases were treated surgically, followed by a combination of chemotherapy and radiation treatment in the otolaryngology department. Approximately 80% of the cases received intervention by the oral care support team before the initiation of cancer treatment. The monthly average number of intervention cases was 6. The rate of postoperative complications was 8.8%. Treatments given by the oral care support team included oral health treatment (tooth and oral mucosal care) in all cases, followed by surgical treatment in 37 cases (35.3%), prosthetic treatment in 16 cases (15.7%), conservation treatment in 5 cases (4.9%), endodontic treatment in 5 cases (4.9%), and caries prevention treatment in 5 cases (fluoride application to tooth surface, 4.9%). Conclusion: Almost all the referred patients required oral functional maintenance. There were no serious adverse events due to intervention by the oral care support team. Further investigation is necessary to establish appropriate therapeutic policy guidelines for dental diseases requiring oral maintenance.