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Preradiation dental extraction decisions in patients with head and neck cancer
H H Bruins1, D E Jolly, R Koole
1Department of Oral & Maxillofacial Surgery, University Medical Center Utrecht, University of Utrecht, The Netherlands.
Objective:
The first objectives of this international survey were to study how dental-related and radiotherapy-related risk factors influence clinicians' preradiation dental decision making in patients with head and neck cancer and to evaluate clinicians' degree of certainty in making such decisions. A further objective was to examine the correlation of clinicians' policies with a policy based on a model for dental decision support that was presented in an earlier article.
Study Design:
A consensus questionnaire was mailed to 54 oral-maxillofacial surgeons and hospital-based dentists at a number of international locations. The responses were aggregated and anonymously analyzed through use of a multiple regression procedure.
Results:
Forty-four clinicians returned the questionnaire (response rate, 81%). Nine clinicians (20%) were using printed clinical guidelines for preradiation dental screening. Eighty-eight percent of clinicians' preradiation decisions and 49% of their certainty could be explained by the studied risk factors. Not all risk factors were significant at P <.001. Clinicians' policies showed high correlation (.85) with the policy based on the model for dental decision support.
Conclusions:
The findings support our previous assumption that policies in this field seem to be based primarily on clinical experience and opinions rather than on evidence-based clinical guidelines. We conclude that the clinical usefulness and validity of the model for dental decision support should now be tested and that it could also serve as a training tool.