Oncology

Dental Management of Patients with Radiotherapy — other region (not head & neck)

Radiotherapy outside the head & neck — low oral/ORN risk

Radiotherapy to a region away from the jaws does not carry osteoradionecrosis risk for the mouth. Dental care can proceed; the main considerations are systemic (fatigue, and any concurrent chemotherapy causing low blood counts).

Emergency vs routine management

If EMERGENCY — what to do

• Treat normally; check FBC if radiotherapy involved large marrow areas (pelvis/spine) or concurrent chemotherapy.Ref: Elad S et al. MASCC/ISOO Clinical Practice Guidelines for oral care / mucositis in cancer therapy. Support Care Cancer 2015–2020

If ROUTINE — what to do

• Routine care — osteoradionecrosis risk applies only to the irradiated jaws.Ref: Peterson DE et al. Prevention and Management of Dental Disease in Patients Undergoing Head & Neck Radiation — ISOO/MASCC/ASCO Guideline. J Clin Oncol 2024

Clinical precautions

• No ORN precautions needed for the jaws
• If also on chemotherapy, check blood counts (ANC/platelets) before invasive care
• Coordinate timing with the oncology team around treatment cycles

At a glance by procedure

Initial assessment before lab results or timing details are entered.

Procedure	Initial assessment
Examination / radiographs	ROUTINE Radiotherapy outside the head & neck — low oral/ORN risk
Supragingival scaling / polish	MODIFY / CAUTION Radiotherapy outside the head & neck — low oral/ORN risk
Deep scaling / subgingival RSD (subgingival calculus)	MODIFY / CAUTION Radiotherapy outside the head & neck — low oral/ORN risk
Root canal treatment	MODIFY / CAUTION Radiotherapy outside the head & neck — low oral/ORN risk
Simple extraction (1–3 teeth)	MODIFY / CAUTION Radiotherapy outside the head & neck — low oral/ORN risk
Surgical / bony extraction	MODIFY / CAUTION Radiotherapy outside the head & neck — low oral/ORN risk
Implant placement	MODIFY / CAUTION Radiotherapy outside the head & neck — low oral/ORN risk

Get a patient-specific decision in seconds

Combine all conditions, medications, lab results and the planned procedure — with anaesthetic dose calculation, lab requests and a referral letter PDF.

References

Radiotherapy (non–head & neck) — dental considerations
Elad S et al. MASCC/ISOO Clinical Practice Guidelines for oral care / mucositis in cancer therapy. Support Care Cancer 2015–2020
Peterson DE et al. Prevention and Management of Dental Disease in Patients Undergoing Head & Neck Radiation — ISOO/MASCC/ASCO Guideline. J Clin Oncol 2024

This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.