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Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Presentation 3 - Head and Neck Surgery

Impact of Dental Clearance on Timing of Radiation Therapy for Head and Neck Cancer

Sunday, October 12, 2025
10:24 AM - 10:30 AM EDT
Location: 127
Disclosure(s):
Rebecca S. Arch, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Catherine T. Haring, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Stephen Y. Kang, MD, FACS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Matthew O. Old, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Lauren E. Miller, MD, MBA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Head and neck cancer (HNC) guidelines recommend initiation of adjuvant radiation (RT) within 6 weeks of surgery. Despite this, many HNC patients experience RT delays. Pre-radiation dental clearance is critical to limit later complications, but its role in radiation delay is unknown.

Methods: A single-institution retrospective review was completed for HNC patients referred for pre-radiation dental clearance in 2023. Exclusion criteria included: edentulous, induction therapy delaying RT initiation, palliative RT, or unknown dates for RT and dental clearance. Dental clearance date was defined as the date of dental exam if no dental work needed, or 1 week after dental extractions. Dental clearance delay (DCD) was defined as clearance date more than 5 weeks following initial clinic, biopsy, or resection. Radiation treatment delay (RTD) was defined as adjuvant RT starting more than 6 weeks after cancer resection or primary RT starting more than 6 weeks after the later of initial clinic visit or diagnostic biopsy. Demographic and treatment information including dental work, RT location, and insurance were included. Multivariable logistic regressions were performed to identify predictors of RTD, DCD, and dental extractions.

Results: Of the 162 patients who met inclusion criteria, nearly 60% experienced RTD (n=95). Of those who experienced RTD, nearly half also experienced DCD (n=46). DCD was more likely if patients required dental extractions (OR 7.16, CI 95% 2.77-18.46), and dental extractions were more likely with increasing age (OR 1.05, 1.01-1.10), and Medicaid (OR 6.02, 1.39-25.99) or no insurance (OR 10.69, 1.17-97.71) compared to private insurance. Patients with DCD were more likely to experience RTD (OR 28.77, 6.13-135.08).

Conclusions: In our cohort, DCD was significantly associated with RTD. Patients requiring dental extractions were over 7 times more likely to experience DCD and were more likely to be older, on Medicaid, or uninsured. These findings highlight patients with higher risk for RTD and inform future studies to streamline dental clearance.

    Presenting Author(s)

  • RA

    Rebecca S. Arch, MD

    Resident
    Ohio State University Hospital Program
    Lewis Center, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • EO

    Enver Ozer, MD

    Professor
    Ohio State Univ Med Ctr; OTO
    Columbus, OH, United States

    Disclosure information not submitted.

  • AA

    Amit Agrawal, MD

    Professor
    Ohio State University Hospital, Department of Otolaryngology - Head and Neck Surgery
    Columbus, OH, United States

    Disclosure information not submitted.

  • Catherine T. Haring, MD

    Assistant Professor
    The James Cancer Hospital & Solove Research Institute
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Stephen Y. Kang, MD, FACS

    Professor
    The James Comprehensive Cancer Center
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Nolan B. Seim, MD, MBA

    Associate Professor
    The Ohio State University Wexner Medical Center
    Columbus, OH, United States

    Disclosure information not submitted.

  • MO

    Matthew O. Old, MD

    Professor and Director, Otolaryngology Head and Neck Surgery
    The Ohio State University Wexner Medical Center
    Columbus, Ohio, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • James W. Rocco, MD, PhD

    Chair of Otolaryngology-HNS
    The OSU Wexner Medical Center
    Columbus, OH, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • LM

    Lauren E. Miller, MD, MBA

    Assistant Professor of Otolaryngology - Head and Neck Surgery
    Ohio State University
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.