Review

Edited by an experienced dental hygienist who has worked in a maxillofacial team and general dental practice, this book brings together knowledge from experts who have different roles in the pathway for patients with head and neck cancer (HNC).

This is an attractively produced book with 290 pages in 49 chapters from many contributors, largely UK based, who are experts in their field. It is extensively illustrated and easy to read, with several useful tables and many references. It also has an appendix of support charities.

HNC is increasing in the UK and worldwide, so it is all the more important that the dental profession is knowledgeable about diagnosis, treatment, and oral and dental implications. This book is aimed at dental therapists and hygienists, who play a valuable role in patient care before treatment and longer term, whether working in maxillofacial teams, restorative dentistry, special care or primary care. With increased survivorship and, therefore, patients being seen longer term, readily accessible information is needed.

The book’s design makes it easy to select an area of interest. The chapters are wide-ranging and cover the patient pathway, but are inconsistent in their depth. Section 1 covers detection and risk factors, including helpful information on substance abuse and HPV. A chapter on pathology explains diagnostic procedures. There is a useful flowchart to show the pathway to specialist care, which leads into the section on hospital treatment and the role of the multidisciplinary team in the patient’s journey. The role of different specialists is explained, including the clinical nurse specialist, dietitian, and speech and language therapist. These chapters include management prior to cancer treatment as well as afterwards. The chapter on restorative dentistry includes restoration of function and use of obturators and implants.

As the prevalence of HNC patients increases, knowledge of the treatments and the implications for oral care is valuable for dental practice. Given this, it is surprising that the main chapter on surgical treatment is included here as ‘History of Maxillofacial Surgery’ when it is the main treatment for so many HNCs. Rather than including it at the beginning of the treatment sections, the book opts instead to start with chemotherapy and immunotherapy.

Radiotherapy, proton therapy and newer surgical techniques of transoral resection and lasers are included, as well as management of the laryngectomy. Discussion of technological advances, including the use of holograms, is an interesting addition.

The wide-ranging side-effects of treatment are covered over several very thorough chapters with plenty of helpful tables. Understandably, these concentrate mostly on the toxic effects of radiotherapy. However, the chapter on osteoradionecrosis gives only scant mention of newer pharmacological treatments – with greater weight being given to hyperbaric oxygen. It would have been helpful to discuss the efficacy of these managements.

The management of extractions after radiotherapy, when necessary, would be a useful addition. There is a chapter on obturators and skin hair in the mouth, but information about facial prostheses could be added.

Throughout the book there is emphasis on the importance of psychological support, and chapters on mental health and wellbeing pre- and post-treatment are included.

The book finishes with stories of four patients who describe their cancer journeys – a more personal and pertinent ending to a clinically in-depth book. Despite being intended for dental hygienists and therapists, this book would be a useful resource for the whole dental team, who are all very likely to meet someone affected by HNC during their careers.

This is a book that provides a wealth of knowledge all in one place. It would also be a useful resource for non-dental members of the head and neck team; it gives clear information about HNC and its management from many aspects by describing well the contribution of each team member and how they support HNC patients.