A comparison of pre-radiotherapy extractions prior to and during the pandemic at charing cross hospital

Abstract

Osteoradionecrosis has considerable morbidity and can adversely affect the quality of life of patients who undergo radiotherapy as part of the treatment for their head and neck cancer. This can be reduced by a thorough dental assessment and extractions of teeth with poor prognosis prior to radiotherapy, ideally at least ten days before radiotherapy commences. Aim and objectives: The dental department at Charing Cross Hospital has an established pathway to assess patients prior to radiotherapy. The aim of the audit was to evaluate whether during the coronavirus pandemic there was timely dental assessment prior to radiotherapy and extractions carried out in sufficient time before start of radiotherapy in accordance with the Royal College of Surgeons 2012 guidelines. Method: Data was collected retrospectively from patient records over two eight monthly periods (May 2019 -Jan 2020 prior to the pandemic and April 2020 – November 2020 during the pandemic). Parameters analysed included: the number of patients referred; time interval between referral and assessment; number of patients requiring extractions and time interval between extraction completion and commencement of radiotherapy. Results: Seventy-six patients with head and neck cancer were referred for dental assessment over the audit period. The most recent audit showed 96.4% of patients were assessed within ten days of referral. Extractions were undertaken on 63.6% of patients, 92.9% were in excess of ten days before radiotherapy, 42.9% over 20 days. Conclusions: National guidelines for extractions are being met in 92.9% of cases and the majority in excess of minimum timing recommended. The dental clinic is providing quality care for this patient group as measured by this audit, showing a positive service outcome.

Keywords

• Head and neck cancer
• Dental assessment
• Multi-disciplinary clinic