Dentists' perspectives on denture provision after radiotherapy for head and neck cancer: an exploratory study using the theoretical domains framework. Br Dent J 2021; http://doi.org/10.1038/s41415-021-3668-6
The authors of this study recognised that patients are often keen to replace missing teeth following radiotherapy and current evidence details numerous benefits in doing so. They acknowledged that this is not always carried out and so sought to explore dentists' perspectives on providing dentures to these patients. Specifically, they asked if the risk of ORN was a consideration affecting dentists' treatment intentions. An online survey was used to gather responses from 150 GDPs and 25 multidisciplinary team dentists across England. Dentists responded to questions based on a clinical scenario detailing a post-radiotherapy patient suffering from xerostomia and pre-treatment extraction of mandibular molars and second premolars. A significant proportion (27%) of respondents decided against denture provision at all, citing factors such as xerostomia affecting denture tolerance and increased caries risk. Of these, 19% cited an increased risk of ORN as influencing their decision. Most dentists (73%) indicated they would provide a denture in this scenario and described generalised benefits of denture provision including improved function, non-invasiveness and cost-effectiveness. The latter group and majority are in keeping with current guidelines which promote the use of removable prostheses and report no evidence of increased risk of ORN. While focusing on just one clinical scenario, the exploratory nature of this study allowed for interesting free-text responses shedding light on the different perspectives of dentists in both general practice and hospital settings. It found that increased awareness of the benefits of dentures in post-radiotherapy patients increases the likelihood of dentists choosing this treatment option. As such, ongoing education in this area seems key to support practitioners and promote evidence-based clinical practice.
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