Post-Radiation Dental Care Access Among Head and Neck Cancer Survivors: A Safety Net Perspective

This study describes dental care access among individuals with head and neck cancer (HNC) at Zuckerberg San Francisco General Hospital (ZSFG), a large, public, safety-net hospital that serves a substantial underserved population.

We identified a convenience sample of participants ≥ 18 years of age through review of routine outpatient HNC surveillance visits. Surveys were translated to Spanish and Simplified Chinese by certified medical interpreters. We used descriptive statistics to summarize findings and logistic regression to analyze predictors of dental care access, represented with odds ratios (ORs), 95% confidence intervals (CIs), and p-values. Statistical significance was defined as a two-sided p-value < 0.05.

Among 41 participants, the majority were male (63%) with a median age of 59 years [interquartile range (IQR) 48-64]. The most represented race/ethnicity was Asian (37%). 63% reported seeing a dentist only annually or less frequently both before and after cancer diagnosis. Prescription fluoride product use was reported by 15% of participants (n = 6). On univariate analysis, a non-English primary language was significantly associated with lower odds of dental visits at least twice a year pre-diagnosis (OR 0.19, 95% CI 0.05-0.78; p = 0.021). Participants who reported challenges finding a dentist had lower odds of dental visits at least twice a year post-diagnosis (OR 0.17, 95% CI 0.04-0.77; p = 0.022).

Our findings suggest that HNC survivors in low-resource settings may experience limited access to routine dental care. Targeted interventions to support access to dental care in higher-risk populations may improve adherence to guideline-recommended care at all stages of cancer treatment.

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