In the case of a patient who has undergone radiation for carcinoma of the tongue, what is the best dental management?

In the context of patients who have undergone radiation therapy for tongue carcinoma, dental management must take into account the risk of radionecrosis, which is a serious and often painful complication that can arise from radiation exposure. Radionecrosis can lead to significant morbidity, including difficulty in healing following dental procedures, increased risk of infections, and the potential for severe oral complications.

Choosing to avoid extractions is prudent in this scenario because patients receiving radiation therapy often have compromised blood supply and healing capacity in the irradiated tissues. This makes any surgical intervention, including tooth extraction, particularly risky. The tissue might not heal correctly, and the patient could end up facing extensive complications such as osteoradionecrosis, a condition where the bone becomes necrotic due to radiation exposure.

While other options may seem viable under different circumstances, they do not adequately address the underlying issues faced by patients with a history of radiation therapy. This includes managing the potential for delayed healing and the heightened risk of developing infections post-extraction. Thus, opting for no extraction aligns with the principle of minimizing invasive dental interventions in these high-risk patients, ensuring safer management and better outcomes.