Dental extractions prior to radiotherapy to the jaws for reducing post-radiotherapy dental complications

This review aimed to assess if removing the back teeth before radiotherapy would mean that patients had fewer tooth-related problems after radiotherapy as part of head and neck cancer treatment, when compared to not removing the teeth. Electronic and handsearching found 357 titles of studies but none of them met the inclusion criteria for the review. There is currently no evidence available to answer this complex question.

Authors' conclusions: 

There are no randomised controlled trials to assess the effect of extracting teeth prior to radiotherapy compared to leaving teeth in the mouth during radiotherapy to the jaws.

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Background: 

Radiotherapy as part of head and neck cancer treatment leaves patients requiring much dental rehabilitation in a compromised environment that is difficult for the patient and the dental team to manage.

Objectives: 

To assess the effects of maintaining the patient's natural dentition during radiotherapy in comparison to extracting teeth before radiotherapy in areas that are difficult to access by the patient and the dentist, should reduction in mouth opening occur after radiotherapy to the jaws.

Search strategy: 

We searched the Cochrane Oral Health Group's Trials Register (to 22 November 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 11), MEDLINE via OVID (1946 to 22 November 2012), EMBASE via OVID (1980 to 22 November 2012), CANCERLIT via PubMed (1950 to 22 November 2012), CINAHL via EBSCO (1980 to 22 November 2012) and reference lists of articles. We advertised for currently ongoing studies via the Cochrane Oral Health Group website and the Cochrane Oral Health Group Twitter feed. 

Selection criteria: 

Randomised controlled trials comparing extraction of teeth prior to radiotherapy with leaving teeth in situ during radiotherapy to the jaws.

Data collection and analysis: 

Three review authors independently assessed the results of the searches for inclusion in the review. 

Main results: 

No randomised controlled trials were found.