What Researchers Did
Researchers conducted a systematic review of 14 prospective studies on HBOT as an adjunct treatment for gum disease (periodontitis), jaw bone death from radiation (osteoradionecrosis/ORN), and jaw bone death from bisphosphonate drugs (MRONJ).
What They Found
HBOT showed clear benefits over antibiotics alone for preventing osteoradionecrosis in patients with a history of high-dose jaw radiation, particularly before and after tooth extractions. For treating existing ORN surgical lesions, HBOT did not add significant benefit but also caused no harm. Results for periodontitis treatment were too inconsistent to draw firm conclusions.
What This Means for Canadian Patients
Canadians who have received radiation to the jaw for head and neck cancer face a real risk of bone death if they need a tooth pulled. HBOT used both before and after the extraction can meaningfully lower that risk. This indication, osteoradionecrosis, is covered by OHIP in Ontario as a listed hyperbaric indication.
Canadian Relevance
Osteoradionecrosis (ORN) is an OHIP-covered indication for HBOT in Ontario. Canadians undergoing tooth extraction after jaw irradiation should ask their oncologist or dentist about a pre- and post-operative HBOT referral.
Study Limitations
The 14 included studies varied widely in design, patient population, and HBOT protocols, limiting the strength of pooled conclusions.