Osteoradionecrosis (ORN) is a condition of nonvital bone in a site of radiation injury. ORN can be spontaneous, but it most commonly results from tissue injury. The absence of reserve reparative capacity is a result of the prior radiation injury. Even apparently innocuous forms of trauma such as denture-related injury, ulcers, or tooth extraction can overwhelm the reparative capacity of the radiation-injured bone.
Ref: Osteoradionecrosis of the Mandible
Original Post
Can't vote on this because I haven't suffered from it, therefore I can't answer some of the questions and it won't register a vote without answering all questions!!

I have a dental problem in my mandible, requiring root canal or extraction of a molar. Current symptoms include swollen gum and a swollen lymph node (a surprise as I thought they had all been removed in surgery!) Hospital appointment on Monday - any particular questions I should be asking?
Hello 200

How did it go? Sorry, I missed your question. I am in Melbourne visiting my daughter. Here is my belated advice:

Just make sure they are aware that you had radiotherapy and know which areas were and were not irradiated (as that determines if there is a risk of ORN if you have an extraction). If there is a risk, is the tooth suitable for having root canal treatment and if so, do they have someone experienced (a specialist) to do it or would you be better off having your dentist do this. (Your more experienced dentist (as they do more root canals in practice than in hospital) might feel happier having a letter from the department requesting him to do it.)

Hope that helps.

Best wishes
Hospital thought root canal treatment would work and my tooth survive, so I've been referred back for that. I have my dental work done at the local dental school, very impressed with them as they take ages over everything and the supervising dentists clearly know their stuff.
Hospital have also referred me for an ultrasound on my swollen node, this is happening on Monday.
Update - Ultrasound & needle biopsy of my lymph node done last week, results at the hospital next week.
First stage of my root canal work done Wednesday, next stage in 4 weeks.
I had two lower jaw wisdom tooth extractions. just over 11 years after my RT finished. One side healed up fairly quickly (about 1 month).
The other side took over 6 months of monitoring before some exposed bone healed over ok.

regards tony k
Glad to hear it healed in the end. Did you have to be in an oxygen chamber? I also have a couple of dodgy teeth and my dentist keeps trying to whip one of them out. She won't refer me because I am currently not in pain and I can't refer myself.


Hi suedebottom (nice name!)

As a head/neck cancer patient (RT etc) I am surprised you wasn't referred to Maxillofacial at your local hospital - do push for it.

Maxillo were brilliant - I had a real phobia of my local dentist attempting to do any work on extractions. (My fault - not the dentist)

There are no facilities for hyperbaric oxygen treatment anywhere local to me. I have heard of their efficacy.

good luck - tony k
Realised that I never came back to this post. Needle biopsy of my node was clear - it was just "reactive". Root canal work completed OK, next stage is to crown the tooth for longevity as it has a slight crack in it.

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