Skip to main content
AAO-HNSF 2026 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Scientific Oral Presentation

Care Equity, Quality, and Safety

Incorporating Post-radiation Preventive Fluoride into Head and Neck Cancer Surveillance in a Safety-net Otolaryngology Clinic

Tuesday, October 20, 2026
8:18 AM - 8:24 AM PT
Location: 406A

    Presenting Author(s)

  • AC

    Alyssa Civantos, MD

    Resident Physician
    University of California - San Francisco
    San Francisco, California, United States

    • Co-Author(s)

  • AN

    Armita Norouzi, BA

    Medical Student
    Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco
    San Francisco, California, United States

  • KJ

    Kennedy Johnson, n/a

    Medical Student
    Temple University, United States

  • KA

    Kevin Avelar, BS

    Medical Student
    University of California San Francisco
    San Francisco, CA, United States

  • MD

    Megan L. Durr, MD

    Professor
    University of California San Francisco
    San Francisco, CA, United States

    • Senior Author(s)

  • Mary Xu, MD

    Head and Neck Surgeon
    UCSF
    San Francisco, California, United States

  • Shauna A. Brodie, MS, RN

    Nurse Practitioner
    University of California San Francisco
    San Francisco, CA, United States

Disclosure(s):
Megan L. Durr, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Despite an established relationship between head and neck cancer (HNC) survivorship and oral health, adherence to recommended oral care is challenging, particularly for underserved patients. This study aimed to integrate preventative fluoride treatments into routine cancer surveillance in a public safety-net hospital clinic.

Methods: This is a prospective cohort study with a hybrid type III design, including HNC survivors who completed radiation. Patients were recruited during their clinic visits over a one-year period, completing an oral health quality of life survey (OHIP-14), salivary pH samples, and oral photographs. Fluoride varnish treatments were then administered. An Acceptability, Appropriateness, and Feasibility Intervention Measures questionnaire was provided to patients and clinic providers. Descriptive analyses summarized baseline implementation responses. Repeated measures were analyzed using linear mixed-effects models with estimated marginal means (EMM) for time-point comparisons for oral health outcomes.

Results: Forty-one patients completed the baseline visit, with 63% male and median age of 59 years (IQR 48-64). Eighteen patients had a first follow-up visit, and nine had a second. Amongst participants, >89% agreed that the intervention was feasible, acceptable, and appropriate, with high levels sustained at follow-up. Amongst the 16 providers, >81% agreed that it was feasible, appropriate, and acceptable. Baseline EMM for salivary pH was 6.8 (95% CI 6.6-7.0) and for OHIP-14 scores was 12.8 (95% CI 8.6-17.1), with no significant differences across follow-up visits. Baseline EMM for DMFT scores was 13.8 (95% CI 11.5-16.1), with a statistically significant increase at follow-up (mean difference -0.39, p=0.025).

Conclusions: Implementation of fluoride treatments into an otolaryngology clinic is feasible and acceptable to both patients and providers, with stable qualitative and quantitative outcomes during a one-year period. This study identifies a novel, interdisciplinary approach to enhancing equitable access to care and could be adapted to broader practice settings.