Associations of oral health items of the Vanderbilt Head and Neck Symptom Survey with a dental health assessment.
OBJECTIVE
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.


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.
Dept of Medicine, Vanderbilt University, United States. Electronic address: Leanne.kolnick@vanderbilt.edu.
Leanne
L
Kolnick
School of Nursing, Vanderbilt University, United States.
Jie
J
Deng
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.
Joel B
JB
Epstein
Dept of Diagnostic Sciences and Oral Medicine, College of Dentistry, University of Tennessee Health Sciences Center, United States.
Cesar A
CA
Migliorati
Division of Dentistry, Dept of Oral and Maxillofacial Surgery, Vanderbilt University, United States.
Julie
J
Rezk
Dept of Biostatistics, Schools of Medicine and Nursing, Vanderbilt University, United States.
Mary S
MS
Dietrich
Dept of Medicine, Vanderbilt University, United States.
Barbara A
BA
Murphy
D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy / Q000009:adverse effects; D003430:Cross-Sectional Studies; D003778:Dentures / Q000009:adverse effects*; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D011795:Surveys and Questionnaires; D014313:Trismus / Q000175:diagnosis*; D014987:Xerostomia / Q000175:diagnosis*
Dental health; Head and neck cancer; Toxicities; Trismus; Xerostomia