Abstract
Introduction Patients are often keen to replace their missing teeth after radiotherapy for head and neck cancer (HNC), yet such replacement does not always take place.
Aims This study aimed to investigate the influences on dentists' provision of dentures for patients treated with radiotherapy for HNC, including whether risk of osteoradionecrosis (ORN) is a factor influencing intention to provide dentures.
Methods An online cross-sectional survey including a case scenario, self-reported behaviour and measures of factors (selected using the theoretical domains framework) that may affect dentists' decisions was completed by general dental practitioners (n = 150) and HNC multidisciplinary team dentists (n = 25) in England.
Results Dentists' reluctance to provide dentures for HNC patients post-radiotherapy was often due to concerns about dry mouth and radiation caries rather than risk of ORN. Knowledge of guidelines and beliefs about consequences were independently associated with dentists' intention to replace missing teeth with dentures.
Conclusion The likelihood of replacing missing teeth with dentures increased with awareness of clinical guidance on the use of dentures in HNC and that denture provision would have positive consequences that outweigh the costs.
Key points
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Dentists' reluctance to provide dentures for head and neck cancer patients post-radiotherapy is often due to concerns about dry mouth and radiation caries.
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Dentists rarely noted the risk of osteoradionecrosis as a reason for not providing dentures for head and neck cancer patients post-radiotherapy.
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Dentists' awareness of guidelines and beliefs about consequences were independently associated with their intention to replace missing teeth with dentures.
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Acknowledgements
Thanks go to Dr. Pepe Shirlaw and Dr. Shaid Hussain for their help and effort in distributing the online dentists' survey to the local dental committees' chairs in England. Thanks also go to Dr. Abdulaziz Bakhsh and Dr. Rayan Sharka for their help in the analyses of participants' free-text reports.
Funding
This study was funded by the University of Umm Al-Qura (number: 4360121455), Saudi Arabia as a part of HA's PhD Studentship at King's College London. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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HA and SES contributed to conception, design, data acquisition, analysis and interpretation and drafted the manuscript. MB and MRF revised the clinical aspect of the manuscript. HA, MB, MRF, SS and SES critically reviewed the manuscript. All authors gave final approval and agree to be accountable for all aspects of the work.
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Abed, H., Burke, M., Fenlon, M. et al. Dentists' perspectives on denture provision after radiotherapy for head and neck cancer: an exploratory study using the theoretical domains framework. Br Dent J (2021). https://doi.org/10.1038/s41415-021-3668-6
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DOI: https://doi.org/10.1038/s41415-021-3668-6
