Compliance with oral hygiene and dietary advice for the prevention of post-radiotherapy dental disease among head and neck cancer patients - a qualitative study

Ciaran Moore, Michael Donnelly, Cherith Semple, Ciaran O'Neill, Gerald McKenna

Research output: Contribution to journalArticlepeer-review

Abstract

ObjectivesTo elicit head and neck cancer (HANC) patients’ views about their oral health and to identify potential issues regarding compliance with clinical oral hygiene and dietary advice for the prevention of post-radiotherapy dental disease.

Methods: A purposive sample of twelve HANC patients between 6- and 12-months post-radiotherapy were recruited to undergo a semi-structured interview with a qualitative researcher. A pre-piloted topic guide was used to frame each interview. Qualitative data were analysed via thematic analysis.

Results: Data were categorised into four main themes – ‘How HANC patients perceive oral health’, ‘Cancer diagnosis and cancer care pathway’, ‘Impact of oncology treatment (radiotherapy, surgery, and chemotherapy)’, and ‘Post-oncology treatment recovery’, with 14 subthemes. Oral health was viewed as an important component of HANC patients’ overall physical and mental health post-treatment. Patients’ non-compliance with adequate oral hygiene practice was related to oral mucositis, a “burning” sensation associated with high fluoride toothpaste, forgotten or inconsistent clinical advice, and an inadequate supply of preventive oral hygiene products. The potentially highly cariogenic nature of prescribed nutritional supplements for patients at risk of malnutrition did not tend to be communicated to patients in advance of their prescription.

Conclusions: Adequate oral health is essential for the overall physical and mental well-being of post-treatment HANC patients. Non-compliance with preventive clinical advice increases the risk of post-treatment oral health deterioration and was related to miscommunication, inadequate supplies of oral hygiene products, and treatment-related oral discomfort.

Clinical significance: Post-treatment HANC patients are at increased risk of dental disease. Educational and behavioural techniques should be employed to enhance patients’ compliance with clinical oral hygiene and dietary advice for the prevention of post-radiotherapy dental disease. Patients should be informed about the potentially highly cariogenic nature of nutritional supplements, and these patients should undergo frequent dental recall. Clinical advice regarding oral hygiene and dietary practices needs to be given consistently to HANC patients by different specialists of the HANC multidisciplinary team.

Original languageEnglish
Article number104720
Pages (from-to)1-11
Number of pages11
JournalJournal of Dentistry
Volume138
Early online date21 Sept 2023
DOIs
Publication statusPublished online - 21 Sept 2023

Bibliographical note

Funding Information:
This work was funded by the Public Health Agency, Northern Ireland , through receipt of the 2018 HSC Doctoral Fellowship Award, as well as the Royal College of Physicians and Surgeons of Glasgow, through receipt of the 2018 Ritchie Trust Fellowship Award. These organisations had no involvement in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication.

Publisher Copyright:
© 2023 Elsevier Ltd

Keywords

  • Head and neck neoplasms
  • Radiotherapy
  • Oral health
  • Oral hygiene

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