Patient Care: Oral Health-Related Quality of Life in Head and Neck Cancer—What a New Systematic Review Reveals
A systematic review published in the Journal of Oral and Maxillofacial Surgery analyzed a wide range of studies to consolidate findings on the Oral Health-Related Quality of Life (OHRQoL) in patients diagnosed with Head and Neck Cancer (HNC). The review confirmed that HNC and its associated treatments—especially radiotherapy and surgery—cause severe and long-lasting negative impacts on a patient's daily life, highlighting the necessity of comprehensive dental and psychosocial support.
The findings underscore the urgent need for integrating pre-treatment dental assessments and continuous oral care into standard HNC management protocols.
The Dual Impact of HNC and Treatment
HNC primarily affects the mouth, throat, and larynx, but the treatments designed to cure the disease often damage non-cancerous tissues, leading to chronic oral complications that dramatically reduce OHRQoL.
Treatment Modalities: Both radiotherapy and radical surgery are necessary treatments, yet they induce severe side effects that persist for years after remission.
Physical and Functional Impairment: Patients commonly experience chronic issues such as xerostomia (dry mouth), dysphagia (difficulty swallowing), masticatory difficulties, and speech impairment. These issues affect basic daily functions like eating and communicating.
Psychosocial Distress: Beyond physical symptoms, the review highlighted significant negative impacts on emotional well-being, social life, and self-esteem. The disfigurement often associated with surgery, combined with chronic functional issues, leads to high levels of psychological distress.
The Critical Time Windows for OHRQoL Decline
The systematic review identified specific time points when OHRQoL is most significantly affected:
Post-Treatment: The immediate period following the completion of radiotherapy and/or surgery marks the sharpest decline in OHRQoL, as patients grapple with acute side effects and initial functional loss.
Long-Term Survivorship: OHRQoL often fails to fully recover to pre-diagnosis levels, even years after the cancer is cured. Chronic issues like severe xerostomia and limited mouth opening (trismus) often become permanent, requiring lifelong management.
Implications for Dental and Oncology Teams
The review strongly recommends that clinical protocols be reformed to fully integrate dental care into the oncology pathway:
Pre-treatment Optimization: Mandatory dental assessment and necessary extractions before radiotherapy are crucial to prevent the risk of osteoradionecrosis (bone death).
Lifelong Management: Oral rehabilitation programs, including saliva substitutes, physical therapy for trismus, and routine preventive dental care, must be standardized as part of survivorship care plans to manage the chronic side effects and improve the patient's long-term quality of life.
Original Article Details
Original Title: Oral health-related quality of life in head and neck cancer: What a new systematic review reveals
Source: Dental Tribune (Content referencing the Journal of Oral and Maxillofacial Surgery)
Publication Date: November 28, 2025