No randomised controlled trials to support or refute the extraction or non-extraction of teeth prior to radiotherapy of head and neck

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Globally about 3% of cancers are head and neck cancers.  Dental examination and completion of any necessary treatment is recommended prior to any radiotherapy required for patients with head and neck cancer.

The aim of this Cochrane review was to assess whether the pre-radiation extraction of diseased or non-diseased molars compared to conservative treatment reduced the risk of tooth related complications.

Detailed searches were conducted in the Cochrane Oral Health Group’s Trials Register the Cochrane Central Register of Controlled Trials (CENTRAL), Medline Embase, CANCERLIT, CINAHL and reference lists of articles.  In addition the Cochrane Oral Health Group and twitter feeds were used to advertise for ongoing studies. The search results were assessed by three reviewers independently.  The authors planned to include randomised controlled trials (RCTs) and follow standard Cochrane protocols.  However, no RCTs were identified that addressed the question.

The authors concluded

There is no evidence from randomised controlled trials to support or refute the extraction or non-extraction of healthy or diseased teeth prior to radiotherapy for the reduction of subsequent dental complications.


Eliyas S, Al-Khayatt A, Porter RWJ, Briggs P. Dental extractions prior to radiotherapy to the jaws for reducing post-radiotherapy dental complications. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD008857. DOI: 10.1002/14651858.CD008857.pub2.

NICE – Service guidance on improving outcomes in head and neck cancers

SIGN 90 – Diagnosis and Management of Head and Neck Cancer




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