Radiotherapy and your teeth
Radiotherapy to the head and neck changes the jaw bone and the mouth for life. Looking after your teeth before, during and after treatment is the best way to avoid problems. These are the questions we are asked most often.
After radiotherapy
Why is an extraction riskier after radiotherapy?
Radiotherapy to the head and neck permanently reduces the blood supply to the jaw bone in the treated area. After an extraction there, the bone may not heal and can become exposed. This is called osteoradionecrosis. The risk is lifelong, which is why prevention matters most.
How can I protect my teeth and jaw?
- Have a dental check before radiotherapy starts, so that teeth likely to cause trouble can be removed first
- Use fluoride and see your dentist often after treatment
- Tell every dentist you see that you have had radiotherapy, and where
- Where possible, a root canal treatment is safer than an extraction in the treated area
Will I need hyperbaric oxygen?
Not routinely. A large trial found that hyperbaric oxygen before extractions did not prevent osteoradionecrosis. Extractions in the treated area are best planned with the hospital or cancer centre that treated you.
What else can radiotherapy do to my mouth?
Many people have a dry mouth after treatment, which raises the risk of tooth decay, and some find it harder to open the mouth fully. Your cancer team, dentist and dental hygienist can help with fluoride, saliva substitutes and jaw exercises.
Who should treat my teeth after radiotherapy?
Routine dental care continues with your own dentist. If a tooth in the treated area may need to come out, your dentist will usually arrange this with the hospital or cancer centre that treated you, where the full cancer team and records are available.
References
- Shaw RJ, et al. HOPON: a randomized controlled trial of hyperbaric oxygen to prevent osteoradionecrosis. Int J Radiat Oncol Biol Phys. 2019. PubMed
This page is general information to help you prepare for your consultation. It does not replace an assessment and advice about your own situation.