Oral Health Behavior-Cognition-Awareness education is associated with improved short-term knowledge and long-term oral hygiene in head and neck cancer patients undergoing radiotherapy: a two-phase study.

Authors

Chenxi Sun, Qiang Lin, Fengping Zhang, Yunxia Fu, Chenqu Guo, Xi Rui, Wenpeng He

Published in

BMC oral health. Volume 26. Issue 1. Jul 28, 2026. Epub Jul 28, 2026.

Abstract

The incidence of head and neck cancer (HNC) has increased steadily, and radiotherapy remains a primary treatment modality. However, radiotherapy may induce severe oral complications, including radiation-related caries and osteoradionecrosis of the jaw (ORN). Consequently, comprehensive pre-treatment oral care and patient education are essential. This two-phase study conducted in Guangzhou, China, evaluated the effects of a structured oral health education program on short-term knowledge, behaviors, and long-term oral hygiene outcomes in HNC patients undergoing radiotherapy.
In Phase 1, 63 HNC patients were prospectively enrolled and received a standardized, single-session Oral Health Behavior-Cognition-Awareness (OHBCA) education. Questionnaires assessed knowledge, awareness, and behaviors at baseline and 6 weeks post-intervention. In Phase 2, a retrospective cohort analysis was performed, comparing 24 patients from Phase 1 who completed 12-month follow-up (intervention group) with 19 historical controls who received standard care. Oral hygiene behaviors and clinical indices (e.g., Debris Index, Gingival Index) were evaluated at 12 months post-radiotherapy. Given the exploratory nature of the study and the use of a convenience sample, formal sample size calculation was not performed. Statistical analyses included paired and independent samples tests as appropriate.
In Phase 1, the OHBCA education led to significant, large-magnitude improvements in oral health knowledge, awareness, and self-reported behaviors (all p < 0.01), including reduced tobacco/alcohol use and enhanced hygiene practices. In Phase 2, at the 12-month follow-up, the intervention group demonstrated significantly better oral hygiene indices (e.g., lower plaque and gingival scores; all p < 0.0001) and more favorable self-care behaviors compared to the historical control group.
This exploratory study suggests that a structured pre-radiotherapy oral health education program is associated with significant short-term improvements in patient knowledge and behaviors, as well as superior long-term clinical oral hygiene outcomes. These preliminary, hypothesis-generating findings support the potential value of integrating systematic patient education into the HNC radiotherapy care pathway and underscore the need for validation through prospective randomized controlled trials.

PMID:
42919312
Bibliographic data and abstract were imported from PubMed on 24 Oct 2026.

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