116 an effort has been made to make a distinction based on tumor site, tumor stage, age, and treatment, future research should aim to investigate the discrepancy between mean values and cut-off values, and why more patients had problems 2 years after treatment in comparison to 1 year after treatment (based on the cut-off value), and why this does not translate to the mean values. Previous research showed that the objective MAT and subjective patient-reported outcomes related to mastication have a low correlation and can therefore not be used interchangeably.28 A future study might aim at developing a prediction model with subjective outcomes, to study whether factors found in the current study would be the same when subjective measures are used. A recommendation would be to include a larger study group, to be able to include a larger number of potential predictors in the LMM and thus provide more reliable and focused results. In conclusion, masticatory function can be influenced by treatment for head and neck cancer. Masticatory dysfunction was associated with a greater age, a tumor in the oral cavity, a higher tumor stage, and a shorter time since treatment. The prevalence of masticatory dysfunction ranged from 26% to 38% before and after treatment. It is important to identify patients at risk for developing masticatory problems, to inform them about possible problems that may occur during and after treatment, and to increase awareness about possibilities for patients regarding rehabilitation.
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