Osteoradionecrosis After Childhood Cancer

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Osteoradionecrosis is a problem with bone healing, particularly in the jawbone. It can occur after high doses of radiation have decreased blood supply to the affected bone, causing the bone to die from lack of oxygen. Bones that have died are unable to heal properly after procedures or surgery involving them.

Am I at Risk?

Survivors who received high doses of radiation to the jaw area are at risk for osteoradionecrosis after dental procedures, such as getting a tooth pulled, or surgery involving the jawbone.

Radiation to the following areas often include radiation to the jaw:

  • head or brain
  • area above the roof of the mouth
  • mouth and throat
  • neck or spine
  • area above the collarbones
  • neck, underarm, or chest areas

Survivors who received radiation doses of 50 Gy or higher to the jawbone have the highest risk for the condition.

What Are the Symptoms of Osteoradionecrosis?

Symptoms may occur months to years after radiation. Common ones include mouth pain, jaw swelling, and difficulty opening the mouth fully.

Osteoradionecrosis can be diagnosed by physical examination and imaging studies. In some cases, a surgeon may need to take a small sample of the bone to make a definite diagnosis. Your dentist will review your radiation therapy records to find out the location and dose of radiation that you received.

What Can I Do to Prevent Osteoradionecrosis?

Make sure to tell your dentist if you received radiation that involved the jaw. Your dentist will then obtain information about your radiation treatment before doing any procedures that could lead to osteoradionecrosis.

Also, risk for cavities is higher in people who received large doses of radiation. So, it is important to get regular dental care and take good care of your teeth and gums (see related Health Link: “Dental Health“). Your dentist might order daily fluoride treatments to lower your risk for cavities and getting teeth pulled.

What If I Have Osteoradionecrosis?

Treatment for osteoradionecrosis can help control its symptoms. Salt-water rinses and light scrubbing of affected tissues may be helpful. Antibiotics may help if a wound becomes infected. Oxygen given in a pressurized chamber, called hyperbaric oxygen therapy, is sometimes used to increase the amount of oxygen in the jawbone and improve its chance of healing.

Where Can I Find More Information?

You can find more information on osteoradionecrosis from these organizations:

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