The management of periodontal disease in patients who have received radiation therapy for head and neck cancer

Osteoradionecrosis is a common, serious sequela of radiation therapy for oral cancer. Patients who are to receive radiation therapy should have preradiation dental evaluation and treatment, oral hygiene instruction, and close dental follow-up during and after radiation therapy. Teeth with significant periodontal disease should be extracted before radiotherapy. After radiation treatment, advancing periodontal disease can be initially managed with conservative treatment, scaling and root planing, tetracycline, and good oral hygiene. Periodontal disease is a possible source of infection and may therefore predispose a patient to osteo-radionecrosis.