Surgical Extraction-Related Dental Clearance Delays Before Radiotherapy in Head and Neck Cancer: A Descriptive Study...

Dental clearance prior to radiotherapy (RT) can extend pretreatment timelines in head and neck cancer (HNC). However, its specific contribution to delays is rarely quantified, and no timing benchmarks exist for patients treated with RT without prior surgery. We conducted a retrospective descriptive study at a Canadian tertiary center, including all adults referred for pre-RT dental evaluation between January 1 and December 31, 2022. Delay metrics were defined as days from consultation to surgery, surgery to clearance, and consultation to RT start. Analyses were descriptive, with complete-case calculations. Among 463 patients scheduled for RT, 356 dentate or partially dentate individuals were referred for dental assessment. Of these, 29 (8.2%) required extended healing or multiple follow-ups. Median consultation-to-surgery delay was 6 days (range 0-31), surgery-to-clearance 22 days [8-119], and consultation-to-RT 28 days [15-133]. Six patients (20.7%) experienced delays extending beyond a 42-day period, used here as a contextual benchmark for exploratory comparison rather than as a formal standard. Follow-up was inadequate in 15/29 (51.7%). One patient (3.4%) developed osteoradionecrosis. This study provides the first descriptive quantification of dental clearance-related delays on RT-only patients in a Canadian tertiary center. Although most achieved clearance within expected timelines, a minority experienced clinically meaningful delays linked to prolonged healing and inadequate follow-up, highlighting dental clearance as a modifiable bottleneck in pretreatment planning and supporting the need for standardized reassessment intervals, structured recall systems, and improved cross-disciplinary coordination. Future multicenter studies are warranted to establish operational benchmarks and evaluate targeted quality-improvement strategies.