Hyperbaric oxygen in the management of late radiation injury to the head and neck. Part II: prevention

Osteoradionecrosis (ORN) of the jaws is a feared complication of treatment for head and neck cancer, and understandably much attention has been given to its prevention; good oral hygiene, careful preventative dental care, and extractions done before radiotherapy have been highlighted by many authors. Such necessary dental extractions when the healing capacity of the bone is normal will, it is hoped, reduce the incidence of subsequent ORN. This review considers the optimal dental management of patients before radiotherapy as well as the evidence base for treatment with hyperbaric oxygen (HBO) before extractions in patients who have had radiotherapy.