Proactive Customized Protocol for Oral Management in Head and Neck Cancer Patients Planned for Radiotherapy

Osteoradionecrosis (ORN) is a nemesis of radiotherapy which adversely affects the life of an individual. It is more often seen with conventional external beam radiotherapy using telecobalt machine. Newer radiotherapy techniques are being used in developed nations to circumvent its inherent disadvantages. A higher incidence of ORN is seen in dentate jaws because of extractions done for odontogenic infections in the post radiation period. Systematic evaluation of oral tissues and instituting appropriate therapeutic and prophylactic measures before, during and after completion of radiotherapy is mandatory. In our hospital since we use telecobalt radiotherapy it was deemed necessary to design our own protocol to reduce the incidence of this debilitating complication. Our protocol is based on recommended guidelines and which has been customized to our patient strata. We present the findings of a retrospective study on patients undergoing radiotherapy in whom this oral management protocol was used. This protocol has been effective in reducing the frequency of osteoradionecrosis at our tertiary care hospital.