Dental Extraction & Radiation Therapy
Dental Extraction or Surgery after Radiation Therapy to Neck and Head.
In this post of our “Medication and Dental Surgery: How your medical history influences treatment decisions“ series we are discussing dental surgery after radiation therapy. It is important that we consider such therapy when deciding on your treatment plan. Radiotherapy is designed to damage the cancer cells and cause a tumour to shrink. However the adjacent normal body cells will also be damaged by the radiation too. 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. The narrow blood vessels can no longer deliver the usual quantity of blood to the local area. This is of particular relevance to the bone in the jaws. For example, a patient who previously received radiotherapy to the salivary gland tissue to shrink a tumour, will receive some radiation in the nearby normal tissues, which may include the bone of the jaws. Radiotherapists try to limit the area of radiation scatter and this focusing of the radiation beam is referred to collimation. 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. 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. This can then result in failure of the extraction site or surgical site to heal with the development of a large area of damaged and dying bone at the surgical site. This is referred to as Osteo-radio-necrosis (ORN). If a patient has received radiotherapy of the head and neck region, they must inform the dentist and then the dentist can contact the Radiation Oncologist who will be able to advise on the risk of ORN depending on the site of radiation and the collimation achieved. In some patients who have received radiation therapy it is necessary to arrange for hyperbaric oxygen therapy sessions at the Townsville Hospital before and after surgery to improve the blood supply to the operation site. If this is required, Dr Priestland and the consultant in the hyperbaric chamber at the Townsville Hospital will provide additional details.
Other posts in this series
- Medication and Dental Surgery: How your medical history influences treatment decisions
- Osteoporosis medication influences dental extractions and dental surgery
- Diabetes and dental treatment or surgery
- Knee or hip replacement surgery influences future dental management
- The influence of cardiac disease on dental management
- Anticoagulant and anti-platelet medications influence management of dental extractions and dental surgery
- Angina (heart-related chest pain) medications and dental treatment
- Codeine sensitivity or allergy
- Patients who routinely take steroid medications