The impact of pre-radiotherapy dental extractions on head and neck cancer patients: a qualitative study

Background Head and neck cancer patients (HNC Ps) are recommended to have dental extractions if teeth have a poor prognosis, they are non-functional, interfere with the surgical site or there is a risk of post-radiotherapy (RT) trismus that could prevent access for future care. There is little research available to determine the impact of this approach on patients. Method A qualitative study based on semi-structured interviews conducted with 18 HNCPs who experienced pre-RT extractions. Transcripts were analysed by thematic analysis. Results Pre-RT extractions represented the first significantly invasive stage of care in the cancer pathway. For most participants the experience was made worse by the fact that teeth were often healthy, asymptomatic and were not the actual site of cancer. Tooth extractions had a significantly negative impact on quality of life. Conclusion HNCPs encountered the dental speciality at a stressful point in the cancer pathway. They felt that their information needs about pre-RT extraction were not addressed and choices were limited. Extractions had a profound negative impact. Given the lack of robust evidence and the advent of new technologies, less radical approaches to pre-RT dental treatment planning should be considered.