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Damage to jaw after radiation treatment, what can be done
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Damage to jaw after radiation treatment, what can be done

My brother has had head and neck cancer and now is cancer free.  However due to the extensive radiation treatments he had along with chemo he now is having problems with his jaws.  Apparently it is the scar tissue from the radiation that is causing this problem.  From my readings and research they say its because of the lack of blood in the jaw bones.  I would like to know is there anything at all that can be done.  He has problems when he sees his dentist because he cant' open his mouth wide enough and we all know what happens to the saliva glands with radiation.  I feel with all the technology they have today there has to be something that can be done.  He is not afraid if he has to get faulse teeth but ofcourse wants to keep his real teeth as long as he could, but he is afraid if he has to get faulse teeth he will not be able to open his mouth wide enough to get them in, because of the problems with the scar tissue.  Are there anykind of suggestions that you can offer or ways that this can be corrected or helped.
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Avatar_dr_f_tn
Hi,
You have not described exactly what problems and symptoms your brother is having with his jaw except that he is unbale to open his mouth wide. This condition is known as trismus and can occurs due to scarring and fibrosis in the soft tissues which have been subjected to surgery or radiation. In some cases, involment of these tissues by the primary cancer can also contribute to the scarring after treatment. Since scar tissue is inelastic and has less blood supply, it can lead to contractures and difficulty in opening the mouth. Mouth opening excercises and devises to assist mouth opening can help in such cases. However, the improvement is generally slow and partial.
There is another entity called "osteoradionecrosis" of the jaw which can occur due to reduced blood supply to the mandible. This can occur if the jaw has received high doses of radiation and is more common in people with poor oral and dental hygiene and in persons with advanced cancers of the mouth. This condition is associated with repeated infections of the jaw which can lead to discharging sinuses from the mouth or skin over the jaw, loss of teeth and gradual destruction of the jaw. Depending on the severity, this condition can be managed either conservatively with antibiotics, debridement, hyberbaric oxygen therapy etc; or by surgically removing the necrosed and infected part of the jaw and replacing it with a bone graft or a metal prosthesis along with vascularized tissue flaps taken from another area of the body. This procedure is performed by a maxillofacial surgeon.
All the best
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