Patient-Reported Barriers To Routine Dental Care And Postoperative Maxillofacial Prosthetic Rehabilitation In Head And Neck Cancer Patients: A Cross-Sectional Study

Vollständiger Abstract

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Background: Survivors of head and neck cancer require sustained oral healthcare after cancer therapy; few cases may additionally need specialized maxillofacial prosthetic rehabilitation. Objective: To assess patient-reported barriers to routine dental care among post-treatment head and neck cancer patients and, among those requiring a maxillofacial prosthesis, to characterize barriers to postoperative prosthetic rehabilitation. Methods: A cross-sectional survey was conducted among 194 post-treatment head and neck cancer patients. The routine dental-care questionnaire assessed education and counseling, follow-up, financial access, provider availability, transportation, travel, and persistent oral symptoms. Forty-eight patients (24.7%) required maxillofacial prosthetic rehabilitation and completed an additional 16-item prosthetic-access module scored from 1 (not a barrier) to 5 (very major barrier); scores of 4-5 were classified as major barriers. Proportions were reported with Wilson 95% confidence intervals. Factors associated with unmet dental-care need were evaluated using multivariable logistic regression. Results: The cohort had a mean age of 59.8 ± 10.0 years, and 149 (76.8%) participants were male. Regular post-treatment dental follow-up was reported by 146 (75.3%), whereas 83 (42.8%) reported concern about dental-care costs and 69 (35.6%) reported an unmet dental-care need. Among the 48 patients requiring prosthetic rehabilitation, the most common major barriers were travelling distance (32; 66.7%), financial burden (31; 64.6%), and repeated appointments (29; 60.4%). Limited mouth opening was strongly associated with unmet dental-care need (adjusted odds ratio [aOR] 4.40, 95% CI 2.25-8.60; p