Objective: To analyse sex differences in health-related quality of life (HRQL) before, during and up to 3 months posttreatment of head and neck cancer, and to examine the importance of salivary secretion rate for HRQL posttreatment. Methods: Patients were recruited before starting curative oncologic treatment. Clinical examinations were performed including determination of the stimulated salivary secretion rate. HRQL (EORTC C30 and HN35) was reported at baseline, weeks 2, 4 and 6 during treatment and 3 months after treatment. Results: A total of 56 men and 19 women were included. During treatment, men reported more problems with pain and sexuality, a higher use of painkillers and need for nutritional support during oncologic treatment, while women reported more problems with weight loss and dry mouth. At 3 months posttreatment, women reported more problems and symptoms than men with the highest scores noted for dry mouth, weight loss and sticky saliva. Patients with hyposalivation (<= 0.7 mL/min) posttreatment reported more problems and symptoms compared with those with a secretion rate of > 0.7 mL/min, especially regarding dry mouth, sticky saliva and social eating (p < 0.001 for all three). Conclusion: Problems and symptoms during and postoncologic treatment seem to differ between women and men, which must be taken into consideration by healthcare and dental professionals. Patients with hyposalivation posttreatment have more problems and symptoms and are therefore in greater need of supportive care.

Objective

To investigate current odontological care routines for patients treated for head and neck cancers in the county councils/regions (C/Rs) of Sweden.

Methods

An invitation to fill in a web-based questionnaire was sent to dentists/dental hygienists working in dental clinics in the 12 C/Rs, treating and responsible for the odontological care of patients undergoing treatment for cancer of the head and neck. The questionnaire started with two mandatory and one non-mandatory questions, followed by questions regarding routines before (n = 28), during (n = 23), and after (n = 9) treatment, plus two additional questions, totalling 65 questions.

Results

Four dental hygienists and six dentists in 10 of the 12 C/Rs answered the questionnaire. Three C/Rs stated that they measure both the unstimulated and stimulated salivary secretion rate, and another C/R stated that they measure the stimulated secretion rate only. Similar recommendations were given regarding oral hygiene, salivary stimulants and substitutes, and extra fluoride. However, great variations were seen regarding recommendations for preventing and relieving oral mucositis. There were also discrepancies regarding information about the importance of avoiding smoking and alcohol. In seven C/Rs, patients visited the dental hygienist once a week during cancer treatment.

Conclusion

The results suggests that there are great variations in odontological care given to patients undergoing treatment for cancer of the head and neck region in different county councils/regions in Sweden. There is a need to develop and implement evidence-based guidelines to decrease the risk of oral complications and increase both the quality of life and the quality of care.