The British Dental Association cited in 2024 that there was an unmet need for NHS dentistry in England, affecting 13 million adults. This translates to well over 1 in 4 of the adult population (28%). This figure represented an increase from the 2023 data, and the problems of access pre-dated the Covid pandemic. Despite the government pledging to increase access to urgent appointments in 2024, the actual figures account for merely a drop in the ocean – some 700,000 to 1 million additional appointments for what are deemed to be urgent conditions. However, the chief dental officer has stated that the scope of the additional appointments, as well as the definition of ‘urgent’, is too narrow. All of the above is compounded by the health inequalities seen in relation to poverty, deprivation and socioeconomic class. These factors are also key influences on head and neck cancer, with this portion of the population being at higher risk of developing malignancy in general. The editors’ choice in this issue looks at adherence to dental care following head and neck cancer treatment and survivorship. Rates varied between 19% and 93%, covering interventions ranging from daily fluoride use through to dental consultation within one year of completing radiotherapy. Unsurprisingly, the article found that better adherence to post-treatment dental care was associated with improved oral health outcomes and better quality of life. Barriers to this included lower socioeconomic status, smoking, older age and advanced cancer stage, lack of access to dental services and engagement from dentists, and a lack of clarity around who should be providing dental care. The authors conclude that adherence to dental care post-radiotherapy requires multidisciplinary engagement with these issues. Sadly, in the UK, patients who have undergone lifesaving cancer treatments do not have free access to dental care, despite the multitude of long-term oral and dental conditions that arise directly as a result of their treatment. We have also all seen the emergency work that comes through the front door due to a lack of basic dental care in the community. In February 2026, the government pledged to increase the scope of the target for improving access to dental services to include all dental appointments. Let’s hope that, with yet another change in prime minister, this does not simply get forgotten about. As always, the editors would like to thank all of our journal reviewers for their valuable contributions.
– Nazia and Gaynor
Long-term effects of head and neck cancer (HNC) radiotherapy treatment include complications impacting oral health – for example, xerostomia, mucositis, osteoradionecrosis (ORN) and dental or periodontal disease. These symptoms have significant functional impacts, including pain and difficulties swallowing and communicating. Adherence to dental care is a key part of HNC survivorship following treatment, but this remains difficult for many reasons including financial challenges and health literacy. The authors of this scoping review evaluated the current literature relating to adherence to dental care, existing barriers, oral health outcomes and impact of interventions to improve care. Inclusion criteria were studies that reported on rates of dental outcomes and adherence to dental care following radiotherapy for HNC. Of the 103 studies screened, 12 were eventually included in the review, comprising a pooled sample size of 2925 patients. Adherence to dental care varied widely between the studies (19–93%), as did the adherence measure reported – for example, daily fluoride compared to dental consultation within one year of finishing radiotherapy. Better adherence was associated with better oral health outcomes and better quality-of-life outcomes. Patient-level barriers were identified as lower socio-economic status, smoking, older age and advanced cancer stage. Systems barriers included lack of access, lack of engagement from dentists and lack of clarity around who should be providing dental care. The interventions reported in the review could be defined as patient education, systems-level redesign and structured clinic-based follow-up programmes. The authors conclude that adherence to dental care post-radiotherapy for HNC is a complex, multifactorial issue requiring further research to develop implementation strategies and multidisciplinary engagement with the issues.
Adherence to Dental Care in Head and Neck Cancer Patients Post-Radiation Therapy: A Scoping Review.
Eltawil Y, Johnson K, Aquasieer Y, et al.
LARYNGOSCOPE
2026;136(7):2856–67.
