If you’re having radiation therapy to the head and neck, your dentist plays an important role in your care. One reason is to help reduce the risk of a condition called osteoradionecrosis (ORN).
Although ORN is uncommon, it can be a serious complication of radiation treatment, making prevention and early management essential.
What is Osteoradionecrosis?
Osteoradionecrosis occurs when radiation reduces the blood supply to the jawbone. This makes it harder for the bone to heal after injury, infection, or dental treatment.
The lower jaw (mandible) is affected more often than the upper jaw because it has a relatively lower blood supply.
Who Is at Risk?
ORN mainly affects people who have received high-dose radiation therapy to the head and neck, particularly for the treatment of cancers involving the mouth, throat, or jaw.
The risk is increased by:
- Tooth extractions after radiation therapy.
- Poor oral hygiene or untreated dental disease.
- Smoking.
- Poorly fitting dentures that cause ongoing trauma.
- High radiation doses to the jaw.
What Are the Symptoms?
Symptoms can develop months or even years after radiation treatment and may include:
- Pain or swelling in the jaw.
- Exposed bone inside the mouth that doesn’t heal.
- Difficulty chewing or opening the mouth.
- Loosening of teeth.
- Persistent infection or drainage.
- In severe cases, jaw fracture.
Any area of exposed bone that doesn’t heal should be assessed promptly.
Can It Be Prevented?
The best treatment for ORN is prevention.
Before starting radiation therapy, patients should have a comprehensive dental examination to identify and treat teeth that may cause problems in the future.
After radiation treatment, it’s important to:
- Maintain excellent oral hygiene.
- Attend regular dental check-ups.
- Use fluoride as recommended by your dentist.
- Avoid smoking.
- Keep dentures well fitted.
- Always tell your dentist if you’ve had radiation therapy before any dental procedure is planned.
If a tooth needs to be removed after radiation therapy, special precautions and careful planning are often required.
How Is It Treated?
Treatment depends on the severity of the condition and may include:
- Careful cleaning of the affected area.
- Antibiotics if infection is present.
- Pain management.
- Special mouth rinses.
- In more severe cases, surgery to remove damaged bone and reconstruct the jaw.
Your dentist may work closely with your radiation oncologist and oral and maxillofacial surgeon to provide the best care.
The Bottom Line
Osteoradionecrosis is an uncommon but important complication of head and neck radiation therapy. The good news is that careful dental assessment before treatment and regular dental care afterwards can greatly reduce the risk.
At Dural Dental Practice, we work with patients before, during, and after cancer treatment to help protect their oral health. If you’ve had radiation therapy to the head and neck, let us know before your appointment so we can provide the safest and most appropriate care for your smile.
