Objectives: The aim of this study was to review the profile and management of patients referred in the first year to a newly established restorative dentistry oncology clinic. A pilot Dental Oncology service was established from December 2002 at the Royal Group of Hospitals, Belfast. This service involves a dental presence at the Head and Neck Cancer Regional Clinic and identified patients subsequently seen at the School of Dentistry for comprehensive clinical assessment. Methods: Completed proformas allowed the formation of a data base which was analysed at the end of the clinic’s first year of service. Results: Sixty five patients were referred, 48 males and 17 females, with a mean age of 59 years (range 22-82, s.d. ± 11.5) and involved a total of 268 patient visits. Seventy one percent of patients were not registered with a dental practitioner. Diagnoses were as follows (%): Lips and oral cavity 17, pharynx 34, larynx 31, paranasal sinuses 9, thyroid 2, unknown primary 5, and other 2. Sixty nine percent gave a positive smoking history. Eighty three percent of patients were dentate. Sixty nine percent had had or were planned for surgery, 51% were pre-radiotherapy, 37% post-radiotherapy and 12% were not scheduled for this treatment. Dental treatment involved 49% of patients requiring extractions, 20% plastic restorations, and 39% had removable prosthetic treatment. Conclusion: It was concluded that there is a need for a hospital based restorative dental oncology service. At present, the services provided by the clinic do not feature in departmental budget of the hospital. The intention is to formalise this service to improve the quality of life for patients with malignant disease who are receiving cancer therapy that has implications for oral comfort and function, by promoting consistent high standards of oral care through a coordinated team approach.