Use of oral nutritional supplements in irradiated patients with head and neck cancer

ObjectivesMalnutrition is common among patients with head and neck cancer (HNC) and associated with poorer outcomes. Oral nutritional supplements (ONS) are often prescribed, with concerns raised about their cariogenicity. This study examined ONS use and caries experience in patients with HNC 12months post-diagnosis. MethodsFifty-four patients with HNC referred for pre-radiotherapy dental assessment were recruited. Data collected included: age, gender, residential postcode, smoking, alcohol use, HNC characteristics, dental history, oral hygiene habits, dietary advice and ONS use. Data was collected at diagnosis, during radiotherapy and 6weeks, three, six- and 12-months post-treatment completion. ResultsFifty-one subjects completed the study. 76.5% of the participants used ONS for an average of 13.8weeks. Caries developed in 22.9% of ONS users and 11.1% of non-users (p=0.6585). The mean overall duration of ONS use was 18.7weeks for the caries group and 8.5weeks for the caries-free group (p=0.1507). Lack of collaboration and disconnection was noted between dietary advice given by dieticians and dentists. ConclusionsONS use is common among patients with HNC. Larger studies are needed to establish the reasons for caries development and impacts of ONS use on oral health. Importance of multidisciplinary management of malnutrition is highlighted.