Maxillofacial Prosthetics After Radiotherapy: Dry Mouth, Tissue Changes and Timing the Fitting

The first thing she noticed was not the missing palate. It was the water glass. Six weeks after the last radiotherapy session, a sip that used to vanish now sat in her mouth like something foreign, and the temporary plate that had fitted so snugly at the start of treatment had begun to rock when she spoke. Her prosthodontist was not surprised. Radiation, she was told, keeps working on tissue long after the machine switches off.

People who need maxillofacial prosthetics after radiotherapy are usually asked to hold two ideas at once: that a well-made prosthesis can restore speech, swallowing and a face they recognize, and that the tissues it rests on are still changing. That tension shapes almost every decision, from the material used to the month an impression is taken.

This explainer walks through what those changes are, why dry mouth matters more than most people expect, and how care teams usually think about timing. It cannot tell you what your team will decide. It can help you understand the reasoning.

What maxillofacial prosthetics after radiotherapy actually involve

A maxillofacial prosthesis is a custom-made device that replaces a missing part of the face, jaw or mouth that cannot be rebuilt with the person’s own tissue, or that is better rebuilt with a removable device. The specialist who plans and makes it is a maxillofacial prosthodontist, a dentist with extra training in cancer and trauma rehabilitation, usually working alongside an anaplastologist, a technician who sculpts and colors facial prostheses.

After head and neck cancer, three situations bring people to this clinic. Surgery has removed part of the upper jaw or palate, leaving an opening between mouth and nose. Surgery has removed an ear, nose or eye and its socket. Or radiation has damaged teeth and jawbone so severely that conventional dentures no longer sit comfortably on the gums.

Radiotherapy changes the job in a specific way. A prosthesis works by resting on, gripping or attaching to living tissue. Radiation alters that tissue: it dries it, thins it, stiffens it and reduces its blood supply. The device therefore has to be designed for a surface that is less forgiving than healthy mouth lining, and the timing of each stage has to respect a healing process that runs slower and longer than it would in an unirradiated jaw. The National Cancer Institute describes these late effects, including dry mouth, fibrosis and reduced bone healing, as changes that can persist or progress for years after treatment ends.

The practical consequence is a staged approach. Most people receive a series of prostheses rather than one: something immediate to protect the wound and allow eating, something interim as swelling settles, and a definitive device once the tissues have stopped moving. Understanding that sequence is the single most useful thing a patient can take into the first appointment.

Examples of maxillofacial prosthetics people are commonly offered

The category is broader than most people realize, and the names tend to arrive without explanation. A short glossary helps.

• Obturator. A plate that closes a surgical opening in the roof of the mouth after part of the upper jaw has been removed, an operation called a maxillectomy. It restores the seal needed to swallow without liquid entering the nose and to make clear speech sounds. It may also carry replacement teeth.
• Palatal lift or augmentation prosthesis. A device that supports a soft palate that no longer lifts properly, or that thickens the palate so a weakened tongue can press against it during swallowing.
• Mandibular resection prosthesis. A lower denture adapted for a jaw that has lost a section of bone and now deviates on closing.
• Auricular, nasal and orbital prostheses. Silicone replacements for an ear, nose, or eye with its surrounding eyelids and socket, colored to match surrounding skin.
• Radiation carriers and positioning stents. Devices made before treatment that hold radioactive sources in place, shield healthy tissue, or keep the tongue and jaw in the same position at every session so the beam lands where planned.
• Implant-retained prostheses. Any of the above anchored to titanium fixtures in bone rather than held by suction, clasps or adhesive.

Which of these applies depends on what surgery removed, what radiation touched and what tissue remains. A person with a small palatal defect and intact teeth may need only a clasp-retained obturator. Someone whose nose was removed and whose surrounding skin received a full radiation dose may need an adhesive-retained facial prosthesis first, with the question of bone anchors deferred until the skin and bone have had time to recover.

None of these is a fixed prescription. The list is the menu, not the order.

How radiotherapy changes the mouth and face over time

Radiation damages rapidly dividing cells, which is why it works against cancer and why it inflames the mouth lining during treatment. The lining, or mucosa, becomes sore and ulcerated, a condition called mucositis, which usually heals within weeks of finishing treatment. The changes that matter for a prosthesis are the slower ones.

Salivary glands are unusually sensitive. Cells in the glands are injured early, and the glands may shrink and scar over months. The result is xerostomia, the medical term for a persistently dry mouth. The NHS and the National Cancer Institute both list radiotherapy to the head and neck among the most common causes of long-term dry mouth, and note that recovery, when it occurs, is often partial.

Small blood vessels in irradiated tissue narrow and close. With less blood flow, tissue becomes fibrotic: firmer, less elastic, less able to repair itself. In the jaw muscles this shows as trismus, a progressive difficulty opening the mouth. In the skin of the face it shows as tightness and a shiny, thin surface. In the jawbone it shows as slow healing after any injury, and in the most serious form as osteoradionecrosis, where a patch of bone dies and becomes exposed in the mouth. The National Cancer Institute describes osteoradionecrosis risk as lifelong after high-dose radiation to the jaws, not a phase that passes.

Teeth suffer twice. Dry mouth removes the buffering and washing action that normally protects enamel, so decay can appear at the gumline and spread quickly. Fibrosis and reduced sensation can also change how firmly someone bites on a prosthesis, altering the forces on the underlying ridge.

These are the reasons a prosthesis that fit in week two may rock in week ten, and why care teams often plan for a moving target.

Why dry mouth changes how a prosthesis fits and holds

Saliva is easy to underestimate until it is gone. A conventional upper denture stays in place largely through a thin film of fluid between the acrylic and the palate. That film creates surface tension and a mild vacuum, the same physics that makes a wet glass cling to a coaster. Remove the film and the denture is left relying on its shape and on whatever teeth or ridges remain.

Dry mucosa also loses its cushioning. Normally moist tissue spreads chewing forces; dry, thin tissue concentrates them, and the border of a plate that once felt smooth can start to rub. Ulcers on irradiated mucosa heal slowly and, over bone, raise the concern of osteoradionecrosis. This is why prosthodontists treating irradiated mouths tend to prefer softer relining materials, shorter denture borders and more frequent adjustment visits than they would for a healthy mouth.

Speech and swallowing depend on saliva too. Sounds like s and sh need a moist palate; a dry obturator surface can add a click or whistle that a small material change may reduce. Food that will not form a soft bolus is harder to move past a prosthesis, so people often describe eating as effortful even when the device fits well.

Management focuses on the symptom rather than the cause. Frequent sips of water, sugar-free lozenges or gum where teeth allow, saliva substitute gels or sprays, and humidified rooms at night are all standard advice in the NHS and MedlinePlus guidance on dry mouth during and after cancer treatment. Medicines that stimulate remaining gland tissue exist; whether one is appropriate depends on how much gland function remains and on other health conditions, and that judgment belongs to the prescribing clinician.

For the prosthesis itself, the honest message is that dryness rarely prevents a device from being made, but it does change what the device can be expected to do and how often it will need attention.

Can I have dental work done after radiation therapy?

Yes, and in many cases dental care after radiation is more necessary, not less. The question is which procedures, in which part of the mouth, and with what precautions.

Routine care is encouraged. Examinations, cleaning, fluoride treatments, fillings and denture adjustments do not injure bone and are part of protecting an irradiated mouth from decay. The National Institute of Dental and Craniofacial Research advises that people who have had head and neck radiation keep close dental follow-up for life, because dry-mouth decay can advance faster than in an unirradiated mouth.

Procedures that break the surface over bone are treated differently. Extractions, gum surgery and implant placement in a region of jaw that received a significant radiation dose carry a risk of osteoradionecrosis, the slow bone death described earlier. That is why teams try hard to remove any doubtful teeth before radiation begins; the NIDCR recommends that extractions happen at least two weeks before treatment starts so sockets can heal. After radiation, an extraction is not forbidden, but it is planned: the surgeon checks the dose map to see how much radiation that segment of jaw received, considers protective strategies, and closes the wound carefully.

Hyperbaric oxygen therapy, in which a person breathes pure oxygen in a pressurized chamber to encourage new blood vessel growth in irradiated tissue, is one strategy used around extractions and implants in some centers. The evidence for it is mixed, with systematic reviews reaching different conclusions, so its use varies and is a decision for the surgical team rather than a standard entitlement.

The practical advice is simple. Tell every dentist you see, forever, that you have had head and neck radiotherapy and roughly where it was aimed. That single sentence changes how they plan even a routine filling.

Can you get dental implants after radiation? What the evidence shows

Dental implants after radiation are possible and are used regularly to anchor obturators, lower dentures and facial prostheses that would otherwise be unstable. They are also higher-risk than implants in healthy bone, and no honest explainer should pretend otherwise.

An implant is a titanium screw placed into the jaw that bone grows onto over several months, a process called osseointegration. The Mayo Clinic describes healing before the final restoration as commonly taking a few months even in unirradiated bone. Irradiated bone has fewer active bone-forming cells and a poorer blood supply, so integration is slower and less predictable, and the surgical wound itself carries the osteoradionecrosis risk described in the previous section.

Several factors shift the balance. Implants in the upper jaw and in the front of the lower jaw tend to be placed in regions that receive lower radiation doses than the back of the lower jaw, and blood supply differs between sites. Continued smoking, poor oral hygiene and uncontrolled diabetes all worsen outcomes. A radiation dose map, which every radiotherapy department retains, allows the surgeon to see exactly how much each part of the jaw received and to choose sites accordingly.

Timing is debated. Published protocols vary, and the systematic review evidence is low in certainty; teams commonly describe waiting periods measured in months after radiotherapy before placing implants, and some prefer to place fixtures during the original cancer surgery, before radiation begins, so integration is well underway when treatment starts. Neither approach has been shown to be clearly superior in high-quality trials.

Extra-oral implants, placed in the skull bone around an ear, nose or eye socket to hold a facial prosthesis with magnets or clips, follow the same logic. The bone is thin, and irradiated skull bone integrates less reliably, so surgeons weigh the gain in retention against the risk of losing a fixture.

The decision is individual. Ask for the reasoning, not just the answer.

Who is usually fitted early and who is usually asked to wait

The pattern across published prosthodontic guidance is consistent even though the details differ: fit early to protect function, delay anything definitive until the tissue is stable.

Fitted early, often on the operating table, are surgical obturators. When part of the palate is removed, a temporary plate made from pre-operative impressions is placed immediately to hold surgical dressing, separate the mouth from the nasal cavity and let the person drink and speak within days. Also early are radiation positioning stents and shielding devices, which by definition must exist before the first treatment session.

Fitted during the interim period, typically while radiotherapy is under way or shortly after, are interim obturators and simple adhesive-retained facial prostheses. These are designed to be relined and reshaped repeatedly as swelling drops and scar tissue contracts.

Asked to wait are definitive devices and anything involving surgery into bone. That includes final obturators with precision fit, implant-retained dentures and bone-anchored facial prostheses. The reasons are practical: an impression taken while tissue is still shrinking produces a device that will not fit in two months, and a surgical wound in bone that is still recovering from radiation has the highest risk of failing to heal.

Some people are asked to wait for reasons that have nothing to do with the prosthesis. Active mucositis, an unhealed surgical site, ongoing chemotherapy, uncontrolled infection, continued smoking, or a need for further cancer surgery all push definitive work back. So does trismus severe enough that impressions cannot be taken safely; jaw-stretching exercises often come first.

A person is rarely told an outright no. Far more often the message is not yet, with a plan for what needs to change first. It is reasonable to ask what that plan is and how the team will know when the time has come.

Timing the fitting: what the weeks and months usually look like

Every pathway is individual, but the shape of the timeline is similar enough to describe. Ranges below are typical patterns described in mainstream patient guidance, not promises.

Before treatment. A dental assessment identifies teeth that are unlikely to survive dry mouth and removes them, ideally at least two weeks before radiation begins according to NIDCR guidance. Impressions are taken for any surgical obturator and for positioning stents. Fluoride trays and jaw exercises are introduced.

Surgery and the first days. A surgical obturator, if needed, is placed in theatre. It is usually removed and replaced with an interim device once surgical packing comes out and swelling begins to fall, commonly within the first couple of weeks.

During radiotherapy. Mucositis makes the mouth sore; interim prostheses may be worn only for eating and speaking, and adjustment visits become frequent. Dry mouth begins and, for many, does not fully return. The National Cancer Institute notes that acute mucositis usually heals within weeks of the final session.

The first months after radiotherapy. Tissues continue to change. Interim obturators are relined. Adhesive facial prostheses can be made once the skin has healed and is no longer moist or peeling. Definitive impressions wait.

Later. Once the treating team judges the tissue stable, definitive prostheses are made. Where implants are planned, the surgical and integration phases add months, since bone healing in irradiated sites is slower than the few months the Mayo Clinic describes for healthy bone.

Two things surprise people most. The first is how many visits the process takes; a definitive obturator can require several appointments for impressions, try-ins and adjustments. The second is that the timeline is not linear: an episode of soreness or a suspected area of exposed bone can pause everything while it is investigated. Building slack into expectations helps.

Obturator, adhesive-retained or implant-retained: a comparison

Retention, meaning how a prosthesis stays put, is the axis along which most options differ. The table summarizes the trade-offs teams commonly discuss for people who have had radiation. It is a framework for conversation, not a ranking.

Approach	How it holds	Usual advantages after radiation	Usual limitations after radiation
Conventional obturator or denture	Suction, remaining teeth with clasps, ridge shape	No surgery into bone; can be made early and adjusted often	Dry mouth weakens suction; pressure sores on thin mucosa; frequent relines
Adhesive-retained facial prosthesis	Medical skin adhesive	No surgery; available soon after skin heals; easily remade	Adhesive can irritate irradiated skin; hold weakens with sweat or oil; daily removal and cleaning
Implant-retained (intra-oral)	Titanium fixtures in jaw with clips, bars or magnets	Stability independent of saliva; less reliance on sore mucosa	Surgery into irradiated bone with osteoradionecrosis risk; slower, less predictable integration; longer timeline
Implant-retained (extra-oral)	Fixtures in skull bone with magnets or bar	Secure hold without adhesive; consistent positioning	Thin, irradiated bone integrates less reliably; skin around abutments needs meticulous care

Notice that the implant rows list the strongest retention and the highest surgical risk. That trade is the heart of most decisions, and it explains why many people spend a long period with a conventional or adhesive device before any implant conversation begins.

Notice also that no row is free of maintenance. Every option requires cleaning, periodic remaking and ongoing dental supervision, and the person’s own hygiene and follow-up attendance influence outcomes as much as the technique chosen.

How serious is maxillofacial surgery in this setting?

The phrase covers everything from an outpatient adjustment of soft tissue to a full-day operation rebuilding a jaw with bone taken from the leg. Seriousness depends entirely on which procedure is meant, so it helps to separate three levels.

Minor procedures include removing a tooth, smoothing a sharp ridge of bone under a denture, or placing a single implant. In a healthy mouth these are routine. In an irradiated jaw the operation itself is still small, but the healing is the concern; the risk of osteoradionecrosis after a tooth extraction in heavily irradiated bone is the main reason teams plan such procedures carefully rather than treating them as trivial.

Intermediate procedures include placing several implants to anchor an obturator or facial prosthesis, sometimes with a graft to thicken bone. These usually involve a general anesthetic or deep sedation, a recovery of days to weeks, and a period of months before the implants can carry a prosthesis.

Major procedures include reconstructing the jaw or face with a free flap, where bone, muscle and skin are moved from elsewhere in the body with their own blood vessels and reconnected under a microscope. These are long operations with hospital stays, and they are sometimes chosen specifically because they bring healthy, unirradiated tissue into a radiated field, which can improve the ground on which a later prosthesis or implant rests.

The risks common to all levels are bleeding, infection, nerve injury with numbness of the lip or chin, and failure of the wound to heal. In irradiated tissue each of these is somewhat more likely, and healing failure is the one surgeons watch most closely.

Asking which level of procedure is being proposed, and what would happen if it were not done, usually produces a clearer picture than asking whether surgery is serious in the abstract.

Living with a maxillofacial prosthesis after radiotherapy day to day

The device leaves the clinic; the dry mouth and fragile tissue come home too. Daily routines matter more here than in ordinary denture care.

Cleaning is twice a day at minimum. Obturators are removed, brushed with a soft brush and mild soap, and the surgical cavity is rinsed with plain water or a prescribed rinse, since food and mucus collect where the palate used to be. Silicone facial prostheses are cleaned of adhesive residue and the skin beneath is washed and inspected for redness. People with implant-retained devices clean around each abutment, the metal post that emerges through the skin or gum, because inflammation there is the commonest reason an implant is later lost.

Remaining teeth need protection that healthy teeth do not. Daily fluoride in custom trays, prescribed by the dental team, is standard advice from the NIDCR for anyone with radiation-induced dry mouth. Sugary sips throughout the day, common when people try to relieve dryness with juice or sweetened drinks, are the fastest route to gumline decay.

Moisture management is continuous. Water at hand, humidified air at night, avoidance of alcohol-containing mouthwashes that sting and dry further, and saliva substitutes when needed are all in the NHS and MedlinePlus guidance. Some people find a small amount of food-safe lubricant on the fitting surface of a prosthesis reduces friction.

Jaw exercises continue indefinitely, because fibrosis keeps tightening. Losing opening range makes cleaning harder, makes future impressions impossible and can eventually prevent a prosthesis from being inserted at all.

Review appointments are not optional extras. Irradiated tissue changes for years, so a prosthesis that was perfect at fitting will need relining or remaking, and exposed bone or new decay is far easier to manage when found early by someone who looks for it routinely.

What people often get wrong about prosthetics after radiation

Myth: once radiotherapy ends, the mouth goes back to normal. Acute soreness usually resolves within weeks, but dry mouth, fibrosis and the risk of osteoradionecrosis are late effects that persist or progress. The National Cancer Institute is explicit that bone risk is lifelong. Planning as though the tissue will recover fully sets people up for disappointment.

Myth: implants are impossible after radiation. They are placed regularly, including in irradiated bone. They are riskier and slower, and site selection using the dose map matters, but a blanket refusal is not what the evidence supports.

Myth: implants are always better than a conventional prosthesis. Better retention is real, but it is bought with surgery into compromised bone and a longer timeline. For some people, particularly those with heavily irradiated lower jaws, a well-adjusted conventional device is the wiser choice, and the team’s reluctance to operate is caution, not neglect.

Myth: a loose prosthesis means it was badly made. Far more often it means the tissue underneath has changed, which is expected. Relining is a normal part of the pathway, not a sign of failure.

Myth: dry mouth is just uncomfortable. It is the main driver of rapid tooth decay after radiation and a major reason prostheses lose their hold. Treating it as a nuisance rather than a condition to manage every day is a common and costly error in terms of teeth lost.

Myth: a facial prosthesis will look artificial. Modern silicone work, colored by hand to the surrounding skin, can be difficult to detect at conversational distance. What no device can do is move like living tissue, and honest teams say so.

Myth: hyperbaric oxygen guarantees healing. Its evidence is mixed and its use varies between centers. It is one tool a team may or may not choose, not a guarantee.

Questions to ask your care team about maxillofacial prosthetics

Consultations move quickly and the vocabulary is dense. Writing questions down beforehand levels the ground. These are the ones experienced clinicians say they wish more people asked.

• Which parts of my jaw and face received the highest radiation dose, and how does that affect where a prosthesis or implant can safely go?
• What sequence of prostheses do you expect me to have, and roughly what has to change in my tissue before each stage?
• How will you decide when my tissue is stable enough for a definitive device?
• If implants are being considered, what is my personal risk of osteoradionecrosis, and what would you do if bone failed to heal?
• Is there a reason to place implants before radiation rather than after, or has that moment passed?
• Would reconstructive surgery bringing in unirradiated tissue change my options, and what would that involve?
• What can I do about dry mouth now, and how much salivary function do you expect to return?
• How often will I need review, relining or remaking, and who do I contact between appointments?
• What jaw exercises should I do, how often, and how will you measure whether they are working?
• Are there any teeth you expect to lose, and is it safer to remove them now than later?
• What signs should make me call you the same day?
• If I decide against implants or against further surgery, what is the alternative plan, and what would I give up?

The last question matters. Every option here has a reasonable alternative, and a good team will describe it without pressure. Bringing someone to take notes, or asking whether the visit can be recorded, helps with recall; people commonly retain only a fraction of what is said in a first specialist appointment.

When to call your doctor

Most problems with a prosthesis are inconvenient rather than dangerous: a rub, a loose fit, a whistle on certain words. Those deserve an appointment within days. A smaller set of signs deserves a same-day call to the treating team, because in irradiated tissue small problems can become large ones quickly.

Contact your team the same day if you notice an area of bone visible through the gum or in the surgical cavity, or a rough hard patch your tongue keeps finding, since exposed bone can be early osteoradionecrosis and is easier to manage when caught early. Call for a mouth ulcer or pressure sore that has not started to heal after about two weeks, or any sore that is enlarging. Call for new or worsening pain in the jaw, particularly if it is deep, aching and not clearly linked to the prosthesis. Call for swelling of the face or jaw, pus or a foul taste, or fever, which suggest infection. Call for bleeding from the surgical site that does not stop with gentle pressure, or for any new numbness of the lip or chin.

Around implants, redness, swelling or discharge at the skin or gum where the post emerges, or a fixture that feels loose, should be reported promptly rather than waiting for the next review.

Seek urgent care, using emergency services where necessary, for difficulty breathing or swallowing, heavy bleeding, sudden severe facial swelling, or a fever with rigors and confusion.

Two symptoms warrant a call even though they feel like part of recovery: a mouth opening that is becoming noticeably smaller week by week, and a prosthesis that suddenly no longer fits after months of stability. Both can signal tissue change the team needs to see. It is always acceptable to ask; a clinician would far rather hear about a false alarm than miss a slow-moving problem in irradiated bone.

Frequently asked questions

Can I have dental work done after receiving radiation therapy?

Yes, and regular dental care is strongly encouraged after head and neck radiation. Examinations, cleaning, fluoride and fillings help protect teeth from the rapid decay that dry mouth causes. Procedures that open bone, such as extractions or implants, remain possible but are planned carefully because irradiated jawbone heals slowly and carries a lifelong risk of osteoradionecrosis. Always tell any dentist that you have had radiotherapy and where it was directed.

What are some examples of maxillofacial prosthetics?

Common examples include palatal obturators that close an opening between mouth and nose after upper jaw surgery, palatal lift devices for a weak soft palate, resection dentures for a lower jaw missing a segment of bone, and silicone prostheses replacing an ear, nose or eye and socket. Radiation positioning stents and shielding devices made before treatment also count. Any of these can be conventional, adhesive-retained or anchored to implants.

Can you get dental implants after radiation?

Dental implants after radiation are placed regularly to anchor obturators, dentures and facial prostheses. They carry higher risk than in healthy bone because irradiated bone has poorer blood supply, integrates more slowly and can develop osteoradionecrosis after surgery. Surgeons use the radiation dose map to choose lower-dose sites and weigh factors such as smoking and oral hygiene. The timing and whether to proceed at all are individual decisions for the treating team.

How serious is maxillofacial surgery?

It ranges from minor procedures such as removing a tooth or placing a single implant to major reconstructions moving bone and skin from elsewhere in the body. After radiation, even minor operations are planned carefully because healing is the main concern, not the size of the procedure. Common risks at every level are bleeding, infection, nerve numbness and failure of the wound to heal, and the last is somewhat more likely in irradiated tissue.

How long after radiotherapy can an obturator prosthesis be fitted?

An obturator is usually fitted before radiotherapy even starts, either during surgery or in the days afterward, so that eating and speaking are possible. What waits is the definitive version. Teams generally delay a final obturator until swelling has resolved, the mucosa has healed and tissue shrinkage has slowed, which is judged individually rather than by a fixed calendar. Interim devices are relined repeatedly in the meantime.

Why does my denture feel looser since radiation?

Two things change. Saliva output falls, removing the thin fluid layer that creates suction between plate and palate, and the tissue under the denture shrinks and stiffens as swelling settles and fibrosis develops. Both loosen a device that fitted well earlier. This is expected rather than a sign of poor workmanship, and relining or remaking is a normal part of care. Report persistent rubbing promptly, since sores over irradiated bone heal slowly.

Will my dry mouth ever improve?

Sometimes, partly. Recovery depends on how much salivary gland tissue lay in the treated area and the dose it received. Some people notice gradual improvement over the first year or two; others have permanent dryness. Mainstream guidance focuses on management: frequent water, sugar-free stimulation, saliva substitutes, humidified air and meticulous dental care. Medicines that stimulate remaining gland function exist, and whether one suits you is a question for the prescribing clinician.

What is osteoradionecrosis and why do dentists keep mentioning it?

Osteoradionecrosis is a condition in which an area of irradiated jawbone loses its blood supply, dies and becomes exposed through the gum, often after an extraction, an ulcer or surgery. It heals poorly and can be difficult to manage, which is why teams remove doubtful teeth before radiation and plan any later bone surgery carefully. The risk does not fade with time, so the caution applies for life.

Is hyperbaric oxygen needed before implants or extractions after radiation?

Not necessarily. Hyperbaric oxygen therapy, breathing pure oxygen under pressure to encourage new blood vessels in irradiated tissue, is used by some teams around extractions and implants. Systematic reviews of the evidence have reached mixed conclusions, so practice varies between centers and it is not a universal requirement. Whether it is offered depends on your radiation dose, the site involved and the surgical team’s protocol.

Can a facial prosthesis be worn during radiotherapy?

Usually not on skin that is actively being treated, because the surface becomes red, moist and fragile and adhesives can worsen the reaction. Some people wear a temporary cover or dressing instead. Once the skin has healed after treatment, an adhesive-retained prosthesis can typically be made. Bone-anchored versions, if considered at all, wait longer because irradiated skull bone integrates less reliably. Your team will advise on timing for your skin.

References

• Cancer Treatments and Oral Health, National Institute of Dental and Craniofacial Research
• Dry mouth, NHS
• Dry mouth during cancer treatment, MedlinePlus
• Mouth cancer treatment, NHS

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.