One form of treatment commonly used for cancer of the head and neck region is radiation therapy. This may be used in combination with chemotherapy and surgery to remove a tumor. Although successful in eradicating cancer, or shrinking the size of a tumor, radiation can cause harmful changes in the jaws that can affect your dental care.
Radiation, directed at the jawbone region can cause the following changes:
- Decrease in healthy bone cells (Hypocellularity)
- Decrease in the oxygen content in the blood supply to the jaw (Hypoxia)
- Decrease in viable blood supply to the jaw (Hypovasclarity)
Complications Of Radiation Therapy
These effects begin immediately during treatment, but to do not become dangerous until approximately 6 months after the completion of radiation.
The LOWER jaw is more commonly involved in this process.
If oral surgery is instituted without taking the proper precautions, a serious condition called OSTEORADIONECROSIS can develop. Without proper evaluation and treatment, this can lead to pain, infection, and possible loss of jaw structure.
Patients At Risk
Patients who are at risk:
- Planning to undergo radiation therapy
- Currently undergoing radiation therapy
- Completed radiation therapy
What is Osteoradionecrosis (ORN)?
Osteoradionecrosis (ORN) is a condition caused by development of non-healing bone in the path of radiation therapy.
Treatment Of ORN
If you have been diagnosed with ORN, treatment may involve a course of HYPERBARIC OXYGEN THERAPY (HBO). HBO is oxygen delivered under high pressure to the affected tissues. Commonly used for patients having decompression sickness, HBO is extremely helpful in treating tissues that are infected or slow to heal. In the case of ORN, HBO is often an important adjunct in healing.
- Those patients planning on undergoing radiation to the head & neck should have a comprehensive dental exam. Any infections or decayed teeth should be treated to reduce the risk of developing ORN.
- If you are undergoing radiation therapy and develop oral pain or swelling, present to Dr. Sultan's office for immediate evaluation.
- If you have already completed radiation therapy and require invasive oral surgery (extractions, gum surgery), you may require a course of HBO before and after dental care.
Patients having undergone radiation therapy are still candidates for dental implants!
Please contact our office should you have any questions regarding the relationship between oral cancer, radiation therapy and oral surgery.