Oral Health Screening Prior to Oncological Treatment-The Helsinki Protocol

Oncological treatments can have adverse effects on oral health and cause long-term complications such as osteonecrosis. This retrospective study investigated the oral health of head and neck cancer patients before radiotherapy and patients with multiple myeloma, breast, prostate, lung, and kidney cancers before antiresorptive therapy.

Altogether 154 patients referred to dental screening before initiation of these therapies at Helsinki University Hospital in 2021 were included. Under the Helsinki protocol, the aim was to assess and treat the patients in a single day, progressing from examination to counseling and, if needed, to extractions.

Before oncological treatment, 61.7% of the patients required at least one tooth extraction due to infection foci. Among antiresorptive therapy patients, multiple myeloma patients had less need for extraction (p = 0.006). Head and neck cancer patients smoked and used alcohol more than antiresorptive therapy patients. Smoking was associated with the need for extractions (p = 0.001).

The Helsinki protocol enables efficient oral health evaluation without delaying cancer treatment. Head and neck cancer patients and antiresorptive therapy patients need dental evaluation before oncological treatment. Over half of patients had infection foci requiring extraction. Multiple myeloma patients showed a lower extraction need than other antiresorptive therapy patients.