Oral prehabilitation for patients with head and neck cancer: getting it right - the Restorative Dentistry-UK consensus on a multidisciplinary approach to oral and dental assessment and planning prior to cancer treatment.

Historically, oral and dental issues for head and neck cancer patients were often not considered until after cancer treatment was complete. As a result, outcomes for oral rehabilitation were sometimes suboptimal. Inconsistencies in service delivery models and qualification, training and experience of staff delivering dental care often compounded this problem, making research and audit almost impossible. Collaborative working by consultants in restorative dentistry from all over the UK as part of a Restorative Dentistry-UK (RD UK) subgroup, renamed more recently as the RD-UK Head and Neck Cancer Clinical Excellence Network (CEN), has re-emphasised the importance of specialist restorative dentistry intervention at the outset of the head and neck cancer pathway to optimise outcomes of patient care. The CEN has driven several initiatives, reflecting Getting It Right First Time (GIRFT) principles aimed at reducing unwarranted variation. This improved consistency in approach and optimised collaborative working of the team now presents a better environment for multicentre audit and research. Ultimately, this should result in a continued improvement in patient and carer experience.

The need for dental treatment in a group of patients undergoing treatment for malignancies other than of the head and neck.

This paper reports the findings of an audit carried out to estimate the dental needs of patients undergoing oncology therapy for malignant disease at various sites of the body. All of the subjects were in-patients on an oncology ward. Over fifty percent of the patients had dental, periodontal or mucosal disease. It was concluded that there is a need to increase the dental service provided to cancer patients to allow further co-ordination between medical, dental and nursing staff for the prevention, management and resolution of oral complications of cancer therapy.

Case report: orthodontic separators as periodontal ligatures in periodontal bone loss.

Periodontal destruction due to subgingival elastic bands was first reported in the dental literature nearly 130 years ago, and has involved over 20 cases. Destruction due to orthodontic separators used during fixed appliance therapy is a less common occurrence. A case report is presented which illustrates the severe periodontal destruction, which can occur when separators are misused. The subsequent treatment of this problem is also described. Emphasis is placed on the correct use of these orthodontic adjuncts and, appropriate monitoring of the gingival health of orthodontic patients.