Oral Health of Cancer Patients: Dentists' Perspectives and Challenges

Abstract

Cancer incidence is growing globally. Cancer therapies are associated with significant adverse effects including oral complications. While dentists have traditionally supported head-and-neck cancer patients in multidisciplinary teams, their broader role in oncology remains under-explored.

This thesis, guided by the Theoretical Domains Framework, aims to (i) explore existing literature on dentists’ knowledge, perceptions, practice and confidence in managing the oral health of cancer patients; (ii) explore Australian dentists’ experience in oncology, their knowledge of cancer therapies, confidence in managing cancer patients and factors influencing their engagement in oncology care.

Two studies were conducted. Study one systematically reviewed literature from 1990 to July 2023, of which 53 met the eligibility criteria. Existing literature primarily investigated dentists’ knowledge of oral cancer (k=28) and an additional two studies investigating knowledge of side effects of radiation therapy to the head-and-neck region. Five studies investigated the role of dentists in cancer care. Studies (k=14) exploring the management of cancer patients found specialist dentists had more involvement with cancer patients than general dentists. Overall, there were more barriers than facilitators identified for dentists to see oncology patients.

Study two surveyed 88 Australian dentists and interviewed 28. Although most reported moderate to high cancer-therapy knowledge and confidence, only a minority had treated more than 10 cancer patients in the previous year. Four main themes emerged that influenced the provision of patient-centred oral care: scope of practice, clinical practice interests, cancer care structure and patient-related factors.

Overall, dentists recognise the importance of oral health in cancer care, but systemic and professional barriers limit involvement.