It is common knowledge that radiation therapy can lead to unpleasant side effects like hair loss or nausea, but you may not know that it can also cause a lot of oral health complications. Radiation therapy can lead to death of your jawbone tissue, known as osteoradionecrosis. Here are five things you need to know about this complication.
How does radiation therapy cause osteoradionecrosis?
Radiation therapy works by killing cancer cells, but this treatment is also toxic to nearby healthy cells. When radiation therapy is used to treat cancers in the head or neck, the radiation may impact the cells that make up your jawbone.
The radiation damages two important types of cells within your jawbone. First, it affects the cells that line your blood vessels, leading to inflammation, and inadequate blood flow to the bone. It also damages the fibroblasts, a type of cell that produces connective tissue. Damage to these two types of cell makes it harder for your jawbone to heal itself.
Osteoradionecrosis may be triggered by trauma to your jawbone such as tooth extraction, oral surgery, jawbone fractures, or even something as simple as irritation from poorly-fitting dentures. A healthy jawbone would be able to heal from these traumas, but an irradiated jawbone cannot heal as well and may die.
What are the signs of osteoradionecrosis?
There are many different signs and symptoms that may accompany osteoradionecrosis. These symptoms include pain within the jawbone or swelling of the surrounding area. You may also develop trismus, also known as lockjaw, a condition that is characterized by the inability to fully open your mouth.
Osteoradionecrosis can also lead to malocclusion, which means that your teeth are crooked, crowded, or have otherwise shifted in position. If you notice any of these symptoms, and have previously undergone radiation therapy, make sure to tell your dentist immediately.
How is it treated?
You may need surgical treatment to remove dead bone tissue. Your dentist will refer you to an oral surgeon if this is required. Missing tissue can later be replaced with bone grafts from other parts of your body to repair the look and function of your jawbone.
To help your remaining tissue heal, you may need hyperbaric oxygen therapy. Your dentist will refer you to a local hospital for this treatment. During this treatment, you will need to sit inside a pressurized room or chamber. The high pressure within this chamber allows your lungs take in more oxygen then you can normally, and this additional oxygen helps boost healing throughout your body. This treatment is not painful, though you may notice a popping sensation in your ears, similar to the feeling you get on an airplane.
How common is this complication?
Osteoradionecrosis, though it doesn’t get as much attention as other radiation complications, is not rare. People who undergo radiation therapy for cancers of the head or neck have a 20% chance of developing osteoradionecrosis of their lower jawbone.
How can it be prevented?
If you have been diagnosed with oral cancer and told that you will soon start radiation therapy, make sure to see your dentist first for a thorough examination. If you have any cavities or other dental problems, they need to be dealt with before you start your radiation therapy. Once the pre-existing problems inside your mouth are dealt with, you will be cleared to start your treatment.
Unfortunately, not all cases of osteoradionecrosis can be prevented. Most of the time, this complication develops within the first six to 12 months following radiation therapy, but you will still be at risk for the rest of your life. This means that any tooth extractions or injuries that you suffer in the future may trigger osteoradionecrosis, so you and your dentist will need to always be alert.
If you are worried about osteoradionecrosis, make an appointment with a dentist at a clinic like Fort McMurray Dental Centre to discuss your options.