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Tooth-level Predictors of Tooth Loss and Exposed Bone after Radiation Therapy for Head and Neck Cancer

The OraRad Study Team has just published tooth-level risk factors that can be used during the pre-radiation dental assessment to predict the risk of tooth loss and exposed bone at that specific site after radiation therapy (RT) for head and neck cancer.

An important finding of the study is that leaving a hopeless tooth in place was the strongest predictor of tooth loss and exposed bone at that specific site within two years after RT.  Leaving a hopeless tooth in place was associated with a 6.4-fold higher risk of developing exposed bone at that site as compared to extracting such teeth prior to RT. Approximately one-third of exposed bone lesions recorded during the two years after RT occurred at the site of a dental extraction done as part of pre-RT dental management. Participants with exposed bone at the site of a pre-RT dental extraction averaged 19.6 days between extraction and start of RT compared with 26.2 days for participants without exposed bone. Other findings of the study include risk ratios for tooth failure and exposed bone based on pre-RT characteristics of individual teeth including untreated caries, pocket depth, furcation involvement, gingival recession, and tooth mobility.

These findings are published in the June 2023 issue of the Journal of the American Dental Association. The citation is below:

Lalla RV, Hodges JS, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Lin A, Brennan MT. Tooth-level Predictors of Tooth Loss and Exposed Bone after Radiation Therapy for Head and Neck Cancer. Journal of the American Dental Association. 154(6):519-528, 2023.

Until 13 July 2023 only, this article can be freely accessed using the link below, provided by the publisher for dissemination within the scientific community:

https://authors.elsevier.com/a/1h80ff0DOElK

The OraRad study is a multicenter prospective observational cohort study, that recruited 572 participants across six clinical sites in the USA. The study is funded by the US National Institute of Dental and Craniofacial Research (NIDCR) through grant number U01DE022939 (Program Officer Dr. Dena Fischer).