Leanne Kolnick1, Jie Deng2, Joel B Epstein3, Cesar A Migliorati4, Julie Rezk5, Mary S Dietrich6, Barbara A Murphy7. 1. Dept of Medicine, Vanderbilt University, United States. Electronic address: Leanne.kolnick@vanderbilt.edu. 2. School of Nursing, Vanderbilt University, United States. 3. Oral Medicine Services, Otolaryngology and Head and Neck Surgery, City of Hope National Medical Center, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, United States. 4. Dept of Diagnostic Sciences and Oral Medicine, College of Dentistry, University of Tennessee Health Sciences Center, United States. 5. Division of Dentistry, Dept of Oral and Maxillofacial Surgery, Vanderbilt University, United States. 6. Dept of Biostatistics, Schools of Medicine and Nursing, Vanderbilt University, United States. 7. Dept of Medicine, Vanderbilt University, United States.
Abstract
OBJECTIVES: The Vanderbilt Head and Neck Symptom Survey (VHNSS) version 2.0 oral symptom subscale addresses underreported oral health issues. We report the associations of xerostomia, dental health, dentures and trismus questions with oral examination findings. MATERIALS AND METHODS: Between May 2011 and April 2012, fifty head and neck cancer (HNC) patients treated with chemoradiotherapy completed the 50-item VHNSS survey, an oral health assessment by a dentist, salivary flow, and inter-incisal opening (IIO) measurements. RESULTS: Patient reported "problems with dry mouth" correlated with unstimulated salivary flow (-0.43, p=0.002). "Cracked teeth" (0.55, p=<0.001) or "difficulty chewing due to teeth" (0.43, p=0.004) correlated with urgent/emergent dental issues identified on clinical exam. Scores of >4 on any dental question identified 83% of patients with urgent or emergent needs. The ROC curve separated routine from urgent/emergent dental issues (0.89, p<0.001). IIO correlated with reported jaw movement "limitations" (-0.43, p=0.002). Small numbers of patients with dentures precluded meaningful analysis of this subsample. CONCLUSIONS: Clinically significant oral health issues pertaining to xerostomia, dental health and trismus may be identified using the oral health subscale of the VHNSS version 2.0. MASCC guidelines should be followed by patients with xerostomia. The observation that a score of >4 is highly predictive of dental issues is important and needs further validation. If confirmed, this would be a useful screening tool for identifying and referring HNC patients for dental care. Patients with trismus should receive physical therapy.
OBJECTIVES: The Vanderbilt Head and Neck Symptom Survey (VHNSS) version 2.0 oral symptom subscale addresses underreported oral health issues. We report the associations of xerostomia, dental health, dentures and trismus questions with oral examination findings. MATERIALS AND METHODS: Between May 2011 and April 2012, fifty head and neck cancer (HNC) patients treated with chemoradiotherapy completed the 50-item VHNSS survey, an oral health assessment by a dentist, salivary flow, and inter-incisal opening (IIO) measurements. RESULTS:Patient reported "problems with dry mouth" correlated with unstimulated salivary flow (-0.43, p=0.002). "Cracked teeth" (0.55, p=<0.001) or "difficulty chewing due to teeth" (0.43, p=0.004) correlated with urgent/emergent dental issues identified on clinical exam. Scores of >4 on any dental question identified 83% of patients with urgent or emergent needs. The ROC curve separated routine from urgent/emergent dental issues (0.89, p<0.001). IIO correlated with reported jaw movement "limitations" (-0.43, p=0.002). Small numbers of patients with dentures precluded meaningful analysis of this subsample. CONCLUSIONS: Clinically significant oral health issues pertaining to xerostomia, dental health and trismus may be identified using the oral health subscale of the VHNSS version 2.0. MASCC guidelines should be followed by patients with xerostomia. The observation that a score of >4 is highly predictive of dental issues is important and needs further validation. If confirmed, this would be a useful screening tool for identifying and referring HNC patients for dental care. Patients with trismus should receive physical therapy.
Authors: Eliane Marçon Barroso; André Lopes Carvalho; Carlos Eduardo Paiva; Barbara A Murphy; Bianca Sakamoto Ribeiro Paiva Journal: BMC Res Notes Date: 2015-10-01
Authors: Lauren A Zatarain; Derek K Smith; Jie Deng; Jill Gilbert; Mary S Dietrich; Kenneth J Niermann; Sheila H Ridner; Barbara A Murphy Journal: Integr Cancer Ther Date: 2018-06-28 Impact factor: 3.279