• Talk regularly with your cancer doctor and dentist about any mouth problems you have during and after head and neck radiation treatment. Buffalo , NY 14263. If teeth require extraction, it would be best to do this before radiation or within a few weeks of starting radiotherapy. Throughout chemotherapy, the dentist must be aware of the degree of immunosuppression of the patient. Chemotherapy The oral complications of chemotherapy depend upon the drugs used, the dosage, the degree of dental disease, and the use of radiation. Dental extractions in patients who had radiation therapy for cancer in the head and neck region carry with them the risks of delayed healing, prolonged alveolar bone exposure, infection, and osteoradionecrosis. He agreed to it because of hearing that infections after radiation can require jaw surgery. Int J Oral Maxillofac Surg 1987; 16(1):56-64. extraction, if unavoidable, should be conservative, using antibiotic coverage and possibly hyperbaric oxygen therapy. After data extraction and risk of bias assessment, prevalence of crown and root defects was assessed. These may include: o Looking at the radiotherapy plans to decide how likely a healing problem will be. Modern medicine often allows radiation treatment today to be focused on a single area, so if you were given radiation therapy on any area of the body or organ further down, such as the liver or breast, and the treatment was very focused, you may be okay to go ahead with dental implants. As part of the damage caused to local body tissue near the tumour, the blood vessels will become partially closed by the formation of scarring or fibrous tissue. Afterwards we recommend that you avoid damaging the area, such as not wearing your denture if it is in contact with the extraction site. Extractions should preferably be undertaken up tothree weeks prior to commencement of treatment.Ten days should be considered a minimum period.iii. (Figure 1). Conclusion. The implications of any dental extractions subsequentto radiotherapy must be sensitively explained to thepatient.ii. Medication-related osteonecrosis of … Your eligibility for dental implants after radiation therapy can depend on where in the body cancer was treated. The criteria used for dental extractions before radiation therapy are not universally accepted and are subject to clinical judgement. One patient had 6 mandibular anterior teeth extracted that were not in the area of direct exposure. After data extraction and risk of bias assessment, prevalence of crown and root defects was assessed. Tooth Extraction Complications: After The Procedure Postoperative Pain. If the radiation has affected the adjacent jawbone, the blood supply will be compromised and the ability of the jaw to repair can be reduced. In 80 cases of ORN Thorn et al (2000) attributed 36 (45%) to extractions after radiotherapy and 8 (10%) to extractions before radio-therapy. Radiotherapy is designed to damage the cancer cells and cause a tumour to shrink. Talk to your dentist or healthcare team about these treatments. Modern techniques have greatly improved the success of collimation reducing the degree of collateral damage to normal tissue during radiotherapy but sometimes the jaws can be affected by the radiation. Osteonecrosis of the jaw (ONJ) involves dead bone in the jaw that becomes exposed after a tooth extraction or, in some cases, from a denture rubbing against the skin in the mouth. 2. However, teeth in the high-dose radiation field should be considered for extraction before radiotherapy if they are nonrestorable; if they require significant restorative, periodontal or endodontic intervention or if they have moderate to severe periodontal disease (pockets of 5 mm or more).6 Radiation treatments for thyroid cancer affect your dental health. Once dental extractions become unavoidable after irradiation, additional care is needed. 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