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


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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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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