215 General discussion 7 General discussion The shift in the focus of head and neck cancer (HNC) treatment from survival to survival with the best possible quality of life (QoL) has increased scientific research attention to the side effects of HNC treatments. Acute and lifelong side effects of HNC treatment include limitations in chewing and swallowing, speech, dry mouth, and social integration associated with decreased quality of life and possible follow-up surgery. Masticatory function and dental health are among the effects that are considered very important by HNC survivors [1]. Chewing or mastication is controlled by teeth, tongue, cheeks, lips, jaw muscles, neuromuscular control, and saliva. The loss of teeth leads to a decrease in functional units and impairs masticatory performance (objective masticatory function) [2, 3]. Impaired masticatory performance leads to the consumption of predominantly soft, easy-to-chew foods, which may result in poor dietary habits and low nutrient intake [2]. In addition, deterioration of masticatory function has been associated with oropharyngeal dysphagia [4, 5] which has signi cant associations with involuntary weight loss [6, 7]. Therefore, it is important to optimize each patient’s masticatory system by minimizing the loss of functional units and optimally restoring the loss. In this thesis, we evaluated masticatory function and oral health-related quality of life (OHRQoL) after prosthetic rehabilitation of edentulous patients with HNC, as well as the accuracy and possible consequences of tooth removal prior to radiotherapy (RT). The edentulous jaw Toothless people are impaired in their chewing function, and even clinically satisfactory full dentures are a poor alternative to natural teeth. The ability of denture wearers to grind food is very poor compared to people with natural teeth. Full denture wearers require, on average, four to eight times more chewing than dentate individuals to achieve the same degree of comminution. This poor chewing performance is compensated for by chewing longer and swallowing coarser food particles. One of the factors leading to the decrease in masticatory performance is the decreased bite force that denture wearers may develop due to the lack of retention and stability of the denture [2]. This lack of retention and stability is exacerbated in patients with HNC by the effects of cancer treatment. Surgical treatment of oral cavity cancer often results in soft tissue and bone defects
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