Dental status of oncology patients requiring bone modulating therapy
Research type
Research Study
Full title
Dental status of oncology patients requiring bone modulating therapy - A retrospective cohort study
IRAS ID
270063
Contact name
Vinod Patel
Contact email
Sponsor organisation
Guys & St Thomas' NHS Foundation Trust
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
There are a significant number of cancers (e.g. breast, prostate, lung, kidney, thyroid and bowel) which in advance stages can spread to bones. Their presence in bones can lead to extensive bone pain, bone fracture and further bone spread. Standard practice is to prescribe bone modulating therapy (BMT) (bisphosphonates, denosumab) to counterbalance the effects of cancer on bones. These medicines have consistently shown to have huge benefits to patients regarding reduced pain, fractures and less cancer spread within the bones. The subsequent effect is a better quality of life for many years.
Prior to commencing BMT it is highly recommended all patients have dental assessment to check their teeth. This is because a significant side effect of these medicines is ‘medication related osteonecrosis of the jaw (MRONJ)’. This simply means jaw bone death. Subsequently patients suffer from pain, swelling, infection, jaw fracture, spontaneous loss of teeth and bad breath. It impacts eating, drinking, speaking and socialising. Furthermore, there remains no guaranteed cure once the condition occurs therefore efforts and focus remain on prevention. Dental extraction and dental infection appear to be the leading cause of MRONJ and therefore the dental assessment is key.
The aim of this research is to assess the dental status of cancer patients with bone involvement who require BMT and to understand the varying difference between them by reviewing past dental x rays and social deprivation scores.
This is a 36 month single centre study conducted at GSTFT commencing 01/01/2020. Retrospective data on this cohort of patients seen between 01/01/2007 and 31/12/2019 will be included in the analysis following attendance on a dedicated pre-BMT dental assessment clinic. This project does not involve direct patient contact. All patients have completed dental treatment. There will be no change or impact to treatment they have undergone. No patients will actively participate.
REC name
London - West London & GTAC Research Ethics Committee
REC reference
19/LO/1600
Date of REC Opinion
18 Oct 2019
REC opinion
Favourable Opinion