Patient Education: Osteoradionecrosis

Print PDF
Clinic Name
Clinic Address
Clinic Phone Number
Clinic Email

We understand that being diagnosed with osteoradionecrosis (ORN) can be overwhelming. We're here to provide you with comprehensive information about this condition to help you better understand it and navigate your treatment journey.

What is ORN?

ORN is a serious complication that can occur in the jawbone as a result of radiation therapy used to treat head and neck cancer. Radiation therapy, while effective in treating cancer, can also affect the blood supply and healing ability of the jawbone, leading to the development of ORN.


The etiopathogenesis of ORN involves several factors:

  1. Radiation Effects: Radiation therapy damages the small blood vessels in the jawbone, leading to reduced blood flow and oxygen delivery to the tissues. This impairs the bone's ability to heal and increases the risk of necrosis (tissue death).
  2. Tissue Hypoxia: Reduced blood flow and oxygen levels in the irradiated bone create an environment of tissue hypoxia, further compromising the bone's ability to repair itself.
  3. Soft Tissue Changes: Radiation therapy can also affect the soft tissues of the mouth, including the mucosa and salivary glands, making them more susceptible to infection and delayed wound healing.
  4. Trauma: Dental procedures that involve trauma to the irradiated jawbone, such as tooth extractions or dental implant placement, can exacerbate the risk of ORN by disrupting the already compromised blood supply and healing capacity of the bone.

Risk Factors:

Several factors may increase the risk of developing ORN, including:

  • History of radiation therapy to the head and neck region, particularly if the radiation dose was high
  • Dental procedures that involve trauma to the jawbone, performed after radiation therapy
  • Poor oral hygiene and untreated dental infections
  • Smoking and alcohol consumption, which can impair healing and increase tissue damage


Symptoms of ORN may include:

  • Pain, swelling, or numbness in the jaw
  • Exposed bone in the mouth
  • Gum infection or inflammation
  • Poor healing of oral wounds


The treatment approach for ORN may vary depending on the severity of the condition and individual patient factors. Treatment options may include:

  • Antibacterial mouth rinses or oral antibiotics to manage infection
  • Pain management medications to alleviate discomfort
  • Surgical procedures to remove or debride (clean) affected bone or tissue
  • Hyperbaric oxygen therapy to improve blood flow and promote healing in the affected area


While not all cases of ORN can be prevented, there are steps you can take to reduce your risk, including:

  • Maintaining good oral hygiene practices, including regular brushing and flossing
  • Informing your dental provider about any history of radiation therapy to the head and neck region
  • Avoiding invasive dental procedures if possible, or coordinating with your radiation oncologist and dental team to minimize risks
  • Discussing the risks and benefits of dental procedures with your healthcare providers


While ORN can be a challenging condition to manage, it's essential to remember that you're not alone. Our team is here to support you every step of the way and answer any questions you may have about your diagnosis and treatment options.

Please don't hesitate to reach out to us if you have any concerns or if you'd like to schedule a follow-up appointment to discuss your ORN further.