How HBOT Can Help Prevent and Treat Osteoradionecrosis
Osteoradionecrosis is a delayed complication that can follow radiation therapy, and hyperbaric oxygen therapy is one option physicians may consider for appropriate patients. In this video, Dr. Michael Cascio of Hill Country Wound Care & Hyperbarics explains what osteoradionecrosis is, how radiation can affect bone, and how HBOT may support prevention and treatment.
Chief Medical Officer | Hill Country Wound Care & Hyperbarics
- Board Certified – Undersea & Hyperbaric Medicine (UHM)
- Certified Wound Specialist (CWS)
- Board Certified – Family Medicine
About This Video
Dr. Cascio opens the video by defining osteoradionecrosis, often called ORN: a condition in which bone tissue dies because of damage from prior radiation therapy. He notes that it most commonly affects the jaw after treatment for head and neck cancers, and then explains the mechanism in plain terms. Radiation can reduce blood flow to the bone, which limits the oxygen and nutrients needed for normal healing, so the bone becomes weak, slow to heal, and more vulnerable to breakdown, infection, or exposure.
He also points out when a problem may show up. An area of radiated bone can break down after dental work, trauma, or even minor irritation, and the symptoms he describes include pain, swelling, exposed bone, poor healing, infection, and difficulty chewing or speaking. That is the context for the rest of the video, which is about what hyperbaric oxygen therapy may offer. HBOT delivers 100% oxygen in a pressurized chamber, which allows oxygen to dissolve more effectively into the bloodstream and reach damaged bone and supporting tissue.
Dr. Cascio then describes what the increased oxygen may support: the growth of new blood vessels in radiated bone and tissue, improved oxygen supply in areas with poor circulation, bone and tissue repair, the body’s ability to fight infection, and tissue strength before and after dental procedures. He explains that HBOT is used preventatively to prepare radiated tissue for dental surgery or extractions, which may lower the chance that ORN will develop, and as a treatment that may help damaged bone recover alongside other medical or surgical care. He closes with what patients can expect: painless, non-invasive sessions that usually last about 90 minutes, a series of sessions around a planned dental procedure for prevention or a longer course for established ORN, possible ear pressure similar to air travel that is usually relieved by swallowing or yawning, and close monitoring by the team throughout each session.
Key Takeaways
- 01
Osteoradionecrosis, often called ORN, is a condition in which bone tissue dies because of damage from prior radiation therapy, and it most commonly affects the jaw after treatment for head and neck cancers.
- 02
Radiation can reduce blood flow to the bone, limiting the oxygen and nutrients needed for normal healing, so the bone becomes weak, slow to heal, and more vulnerable to breakdown, infection, or exposure.
- 03
Dr. Cascio notes that radiated bone can break down after dental work, trauma, or even minor irritation, and that symptoms may include pain, swelling, exposed bone, poor healing, infection, and difficulty chewing or speaking.
- 04
HBOT delivers 100% oxygen in a pressurized chamber, which allows oxygen to dissolve more effectively into the bloodstream and reach damaged bone and supporting tissue.
- 05
The increased oxygen may support healing in several ways: stimulating new blood vessel growth in radiated bone and tissue, improving oxygen supply where circulation is poor, promoting bone and tissue repair, enhancing the body’s ability to fight infection, and strengthening tissue before and after dental procedures.
- 06
Used preventatively, HBOT helps prepare radiated tissue for dental surgery or extractions, which may lower the chance ORN will develop; used as a treatment, it may help damaged bone recover alongside other medical or surgical care.
- 07
Sessions are painless and non-invasive and usually last about 90 minutes. Ear pressure similar to air travel is common and can usually be relieved by swallowing or yawning, and the team monitors patients closely throughout each session.
Full Video Transcript
The full video, transcribed. Dr. Michael Cascio is the only speaker.
And today I’d like to explain how hyperbaric oxygen therapy, or HBOT, can help prevent and treat osteoradionecrosis, often called ORN. Hello, I’m Dr. Mike Cascio, and I’m the chief medical officer for Hill Country Wound Care and Hyperbarics.
Osteoradionecrosis is a condition where bone tissue dies due to damage from prior radiation therapy, most commonly affecting the jaw after treatment for head and neck cancers. Radiation can reduce blood flow to the bone, limiting oxygen and nutrients needed for normal healing. As a result, the bone becomes weak, slow to heal, and more vulnerable to breakdown, infection, or exposure. Sometimes after dental work, trauma, or even minor irritation.
Symptoms of ORN may include pain, swelling, exposed bone, poor healing, infection, or difficulty chewing or speaking.
HBOT helps by delivering 100% oxygen in a pressurized chamber. This allows oxygen to dissolve more effectively into the bloodstream and reach damaged bone and supporting tissue. The increased oxygen supports healing in several important ways. It stimulates the growth of new blood vessels in radiated bone and tissue. It improves oxygen supply in areas with poor circulation. It promotes bone and tissue repair. It enhances the body’s ability to fight infection. And it helps strengthen tissue before and after dental procedures to reduce the risk of ORN.
When used preventatively, HBOT helps prepare radiated tissue for dental surgery or extractions, lowering the chance that ORN will develop. When used as a treatment, it helps damaged bone recover and supports healing alongside other medical or surgical care.
So, what can patients expect? HBOT is painless and non-invasive. You’ll lie comfortably in a specialized chamber while breathing pure oxygen. Each session usually lasts about 90 minutes. Preventative treatment often includes a series of sessions before and after a planned dental procedure, while treatment for established ORN may require a longer course depending on severity and response.
During therapy, you may feel some pressure in your ears similar to what you experience during air travel, which can usually be relieved by swallowing or yawning. Our team will monitor you very closely throughout each session.
The goal of HBOT is to improve blood supply, promote healing, protect the bone, and reduce complications from radiation damage. If you have any questions, our team will guide you through every step of the process. Thank you.
Learn More About Osteoradionecrosis and HBOT
Hyperbaric Oxygen Therapy
Hill Country's overview of hyperbaric oxygen therapy, how HBOT works, and how it may be used as part of a physician-led treatment plan.
Radiation Injuries
How our physicians evaluate and treat tissue damaged by radiation therapy, including the role of hyperbaric oxygen therapy for appropriate patients.
Hyperbaric Oxygen Therapy for Osteoradionecrosis in San Antonio
A written explanation of osteoradionecrosis, who may benefit from hyperbaric oxygen therapy, and what treatment involves for patients in San Antonio.
Could HBOT Be Part of Your Treatment Plan?
Hyperbaric oxygen therapy is used for specific medical indications, and not every patient is a candidate. A physician evaluation can help determine whether HBOT may be appropriate for you and how it would fit into a broader treatment plan. Hill Country Wound Care & Hyperbarics provides physician-led wound care across Greater San Antonio. Medicare and most major insurance plans are accepted.