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Levy BB, Goodman J, Watson E, Gilbert M, Blanas N, Noel CW, Kamalraj P, Wright FC, Irish JC, Conn LG, Eskander A. A scoping assessment of dental services at designated head and neck cancer centres in Ontario, Canada. BMC Oral Health 2024; 24:232. [PMID: 38350886 PMCID: PMC10865540 DOI: 10.1186/s12903-024-03992-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/06/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Dentists serve a crucial role in managing treatment complications for patients with head and neck cancer, including post-radiation caries and oral infection. To date, dental services for head and neck cancer patients in Ontario, Canada have not been well characterized and considerable disparities in allocation, availability, and funding are thought to exist. The current study aims to describe and assess the provision of dental services for head and neck cancer patients in Ontario. METHODS A mixed methods scoping assessment was conducted. A purposive sample of dentist-in-chiefs at each of Ontario's 9 designated head and neck cancer centres (tertiary centres which meet provincially-set quality and safety standards) was invited to participate. Participants completed a 36-item online survey and 60-minute semi-structured interview which explored perceptions of dental services for head and neck cancer patients at their respective centres, including strengths, gaps, and inequities. If a centre did not have a dentist-in-chief, an alternative stakeholder who was knowledgeable on that centre's dental services participated instead. Thematic analysis of the interview data was completed using a mixed deductive-inductive approach. RESULTS Survey questionnaires were completed at 7 of 9 designated centres. A publicly funded dental clinic was present at 5 centres, but only 2 centres provided automatic dental assessment for all patients. Survey data from 2 centres were not captured due to these centres' lack of active dental services. Qualitative interviews were conducted at 9 of 9 designated centres and elicited 3 themes: (1) lack of financial resources; (2) heterogeneity in dentistry care provision; and (3) gaps in the continuity of care. Participants noted concerning under-resourcing and limitations/restrictions in funding for dental services across Ontario, resulting in worse health outcomes for vulnerable patients. Extensive advocacy efforts by champions of dental services who have sought to mitigate current disparities in dentistry care were also described. CONCLUSIONS Inequities exist in the provision of dental services for head and neck cancer patients in Ontario. Data from the current study will broaden the foundation for evidence-based decision-making on the allocation and funding of dental services by government health care agencies.
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Affiliation(s)
- Ben B Levy
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jade Goodman
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Erin Watson
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Melanie Gilbert
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room M1 102, Toronto, Ontario, M4N 3M5, Canada
| | - Nick Blanas
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room M1 102, Toronto, Ontario, M4N 3M5, Canada
| | - Christopher W Noel
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Pabiththa Kamalraj
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room M1 102, Toronto, Ontario, M4N 3M5, Canada
| | - Frances C Wright
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room M1 102, Toronto, Ontario, M4N 3M5, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan C Irish
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, University of Toronto, Toronto, Ontario, Canada
| | | | - Antoine Eskander
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room M1 102, Toronto, Ontario, M4N 3M5, Canada.
- Department of Otolaryngology-Head & Neck Surgery/Surgical Oncology, University of Toronto, Toronto, Ontario, Canada.
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Piras A, Venuti V, D’Aviero A, Cusumano D, Pergolizzi S, Daidone A, Boldrini L. Covid-19 and radiotherapy: a systematic review after 2 years of pandemic. Clin Transl Imaging 2022; 10:611-630. [PMID: 35910079 PMCID: PMC9308500 DOI: 10.1007/s40336-022-00513-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 02/08/2023]
Abstract
Introduction Following the Covid-19 pandemic spread, changes in clinical practice were necessary to limit the pandemic diffusion. Also, oncological practice has undergone changes with radiotherapy (RT) treatments playing a key role.Although several experiences have been published, the aim of this review is to summarize the current evidence after 2 years of pandemic to provide useful conclusions for clinicians. Methods A Pubmed/MEDLINE and Embase systematic review was conducted. The search strategy was "Covid AND Radiotherapy" and only original articles in the English language were considered. Results A total of 2.733 papers were obtained using the mentioned search strategy. After the complete selection process, a total of 281 papers were considered eligible for the analysis of the results. Discussion RT has played a key role in Covid-19 pandemic as it has proved more resilient than surgery and chemotherapy. The impact of the accelerated use of hypofractionated RT and telemedicine will make these strategies central also in the post-pandemic period.
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Affiliation(s)
- Antonio Piras
- Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
| | - Valeria Venuti
- Radioterapia Oncologica, Università degli Studi di Palermo, Palermo, Italy
| | - Andrea D’Aviero
- Radiation Oncology, Mater Olbia Hospital, Olbia, Sassari Italy
| | | | - Stefano Pergolizzi
- Radiation Oncology Unit, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | - Luca Boldrini
- Dipartimento di Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, UOC Radioterapia Oncologica - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, Roma, Italy
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