title: Compliance with fluoride custom trays in irradiated head and neck cancer patients.
abstract: OBJECTIVE
  The purpose of this study is to assess compliance with fluoride gel custom trays in irradiated head and neck cancer patients.
  
  
  METHODS
  One hundred fifty-five consecutive patients on remission following radiation therapy of head and neck cancers were assessed retrospectively for dental care practices prior to radiation and prospectively for long-term compliance with custom trays from November 2009 to January 2010. A five-item questionnaire was filled in by patients in the waiting room, and a 15-item questionnaire by the physician in charge during the corresponding follow-up visit.
  
  
  RESULTS
  Ten percent of patients were edentulous at inclusion. Among dentate patients, 17% had total extractions. With a mean follow-up of 24 months, 19% of patients used custom trays for over a year. Primary stage, age, and tobacco consumption were correlated with compliance with custom trays. More than half of dentate patients developed carious lesions, and 8% had stage 1-3 osteoradionecrosis of the whole population of edentulous and dentate patients.
  
  
  CONCLUSIONS
  Compliance with custom trays was poor in this series. Specific postirradiation dental care follow-up visits and education have demonstrated their utility in the era of 2D irradiation. We currently advocate an 18-month compliance with custom trays in IMRT patients on the basis of the Parsport trial, after which we assess the quality of salivary recovery before recommending prolonged use or interruption. Data with innovative irradiation techniques are however required.
authors.affiliation: Department of Radiation Oncology/Institut Universitaire de la Face et du Cou fo J thariat, Cancer Center Antoine-Lacassagne, University Nice Sophia-Antipolis, 33 Av. Valombrose, 06189, NICE Cedex 2, France. jthariat@hotmail.com
authors.forename: Juliette
authors.initials: J
authors.lastname: Thariat
authors.forename: Liliane
authors.initials: L
authors.lastname: Ramus
authors.forename: Vincent
authors.initials: V
authors.lastname: Darcourt
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Marcy
authors.forename: N
authors.initials: N
authors.lastname: Guevara
authors.forename: Guillaume
authors.initials: G
authors.lastname: Odin
authors.forename: Gilles
authors.initials: G
authors.lastname: Poissonnet
authors.forename: Laurent
authors.initials: L
authors.lastname: Castillo
authors.forename: Ali Mohammed
authors.initials: AM
authors.lastname: Ali
authors.forename: Christian
authors.initials: C
authors.lastname: Righini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002327:Cariostatic Agents / Q000008:administration & dosage*; D003731:Dental Caries / Q000517:prevention & control*; D003762:Dental Instruments; D005260:Female; D005460:Fluorides, Topical / Q000008:administration & dosage*; D005782:Gels; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D002327:Cariostatic Agents; D005460:Fluorides, Topical; D005782:Gels