Dental
Radiotherapy involving your head and/or neck will affect your salivary glands, teeth and jaw. For these reasons I was scheduled to see a maxillofacial and oral surgeon to determine what dentoalveolar surgery would be needed as part of my treatment.
The side effects of radiation may include:
- A dry mouth because some or all the salivary glands have been affected;
- Decay and abscessed teeth due to pulp (the nerve and blood vessels in my teeth) necrosis (tissue death), also caused and worsened by the dry mouth;
- Osteoradionecrosis (ORN); exposed bone in the jaw, due to destruction of the normal cells in the gums (mucosa) and bone by radiation
Osteo – bone
Radio – radiation
Necrosis – tissue death
ORN, although a rare complication of radiation therapy, occurs because the radiation destroys some normal cells as well as the tumour cells. Damage to arterial blood supply causes a reduced oxygen delivery to the irradiated area and circulation to the area can be severely impaired. This process is gradual and it may take many months or years for problems to arise. If I required surgery to the irradiated are at any time during this period then the wound may not heal without the assistance of hyperbaric oxygen therapy.
My maxillofacial surgeon suggested that whilst under a general aesthetic undergoing my radical neck dissection that I have eight molars/sub molars within the radiation field removed. This would help facilitate early healing of my jaw and reduce the chances of complications due to ORN.
On 06 February 2009 I went back to the maxillofacial surgeon to have a check-up on how I was healing prior to starting the radiation and chemotherapy. The dentist found one area (lower right inside of my jaw) that was not healing as expected. I was required to go back on 09 February 09 for a treatment under local anaesthetic which was to pull the two sides of the gum together to cover the jaw. This was to take about 45 minutes and I ended up with 5 stitches on the inside. Whilst in the chair I had bits and pieces of my jaw snapped and ground off.