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RD-UK has produced guidance for MDTs on oral pre-habilitation and rehabilitation for head and neck cancer patients during the Covid-19 pandemic:
- Consultant in Restorative Dentistry (CRD) should attend virtual MDT via e.g. Microsoft Teams.
- Clinician (Surgeon/Oncologist) to arrange dental panoramic radiograph (DPT/OPT/OPG) at time of diagnosis or to coincide with diagnostic imaging.
- CRD will assess DPT prior to MDT.
- Radiology Consultant to consider reformatting existing CT scans to produced dentally focussed images if no OPG available/likely.
- Oral/dental needs for every new patient should be discussed at MDT ‘live’. CRD to identify dentally vulnerable patients with the team. Discussion should be documented at the MDT.
- Minimise face-to-face appointments. Offer consultations via telephone or video consultation wherever possible. Attend Anywhere APP can be used.
- Counsel patients when it is considered that prosthetic rehabilitation may have low/ no chance of success or will be deferred.
- Fewer dental extractions will be prescribed under current circumstances in order to reduce the number of face to face appointments.
- Where there is a certain plan for surgery followed by post-operative radiotherapy, extraction of teeth with very poor prognosis during primary surgery should be considered.
- In order to cut non-essential follow-up visits, follow-up virtual clinics should be developed.
- Prosthetic rehabilitation may need to be deferred and, in some cases, may not be possible.
- Even at this pressured time practices and treatments which are based on evidence and are known to help patients should be employed. Participation by a CRD is considered an essential part of head and neck cancer care. In the event that CRD input to the MDT becomes unavailable during the COVID-19 crisis and in the absence of a local network of CRD, support should be sought from the regional Dental Hospital Restorative department. The RD-UK Head and Neck Cancer Clinical Effectiveness Network can also provide general guidance at rd.uk@nhs.net
- More detailed guidance for CRDs is available on the RD-UK website: www.restdent.org.uk
- Document available here
This guidance will be updated as new information becomes available