1. The impact of COVID-19 on preradiotherapy dental assessments in Northern Ireland
- Author
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Markey, N., Moore, C., Hamilton, K., Cullen, L., and McKenna, G.
- Subjects
SDG 3 - Good Health and Well-being - Abstract
Head and Neck Cancer (HANC) is the eighth most common cancer type in the UK, accounting for approximately 3% of all cancers in the UK, with in excess of 8500 cases annually. There are approximately 400 cases of such cancer in Northern Ireland annually. The peak age range for head and neck cancer diagnosis is between 65−69 years in both males and females, with over 95% of all cases being in individuals over the age of 40 years. Management of head and neck cancer typically entails an extensive multidisciplinary approach. The management may include treatment by surgery or by chemotherapy and radiotherapy, or a combination of modalities.4. The majority of patients receive surgery followed, in approximately 60% of cases, by radiotherapy. Guidance from the British Association of Head and Neck Oncologists states that all patients whose oral cavity, teeth, salivary glands and jaws that will be affected by treatment should have a pre-treatment dental assessment. The aim is to render the patient dentally fit prior to starting treatment. This assessment should be done as early as possible to maximise the time available for treatment. Unfortunately, owing to the complexities of cancer diagnosis, treatment and management, this is challenging. The Northern Ireland HANC multidisciplinary team convene weekly for case discussions. Dentate HANC patients who require pre-radiotherapy dental assessment are identified at the multidisciplinary meeting. These patients are subsequently referred to the restorative dentistry department in the Belfast dental hospital for dental assessment. The Covid-19 pandemic has placed increased stress on healthcare systems worldwide due to critical resource shortages and delays in care. Head and neck cancer has been directly affected from diagnosis to treatment in patients with this disease and even those who have not yet been diagnosed with this pathology. This is due to the interruption of healthcare that has been significantly directed at dealing with the pandemic. The Covid-19 pandemic has required triage and delays in surgical care throughout the world. Outpatient elective activities have been suspended or reduced at times, and a delay in the diagnosis of primary head and neck cancer has been expected. It has also been suggested that a lack of timely access to healthcare could lead to increased presentation of advanced stage HANC. During the ‘first-wave’ of the Covid-19 pandemic in 2020, the Belfast Health Trust suspended a significant number of ‘face to face’ patient appointments as existing staff were redeployed to other service areas to deal with the pandemic. Suspended appointments included ‘face to face’ pre- radiotherapy dental assessments. ‘Face to face’ outpatient appointments recommenced at the beginning of June 2020, after which many hospital services attempted to re-build and function.
- Published
- 2021