Osteonecrosis jaw (ONJ): is from loss of oxygen-rich blood to the bone. This occurs during radiation therapy of the head and neck as the vessels get smaller and healing becomes more difficult, if not, impossible.  That is why non-restorable teeth, or teeth that have a poor long-term prognosis need to be extracted and healing of the soft pink gingival tissue needs to take place prior to radiation therapy.   The main sign of the necrotic bone is visible, exposed bone showing through an opening in the gums that doesn’t heal in many weeks. This can be extremely painful and can lead to serious infections.

That is why before starting head and neck radiation and/or chemotherapy, your physician will require you to visit a prosthodontist for a thorough examination and address all dentally-related concerns prior to initiating his therapy. This is because of the immense changes to your mouth that will occur. There will be very specific windows of opportunity to get cavities and extractions taken care of. A prosthodontist with experience in this complex field will know when those are.

Osteoradionecrosis of the Jaw leading to painful exposed dead underlying bone

Q: Who is at risk for developing ONJ?

A: People undergoing radiation therapy to the neck and head

• People on steroid therapy over a long-term period
• People who use certain types of bisphosphonates to reduce the risk of bone fractures.

Q: What are treatment options for ONJ?

A: Various treatments, such as hyperbaric oxygen therapy, for osteonecrosis of the jaw may be suggested. Special mouth rinses in conjunction with antibiotics may be prescribed.   Severe cases of ONJ still require the removal, via surgery, of the affected bone to keep it from spreading to healthy bone.

It never hurts to get a second opinion, call Dr. Huang at NOVA Premier Dental.  Dr. Huang is a dual-Board Certified Prosthodontist, a Clinical Associate Professor at the University of Maryland, and on staff at Inova Fairfax Hospital, Department of Surgery.