A group of 43 patients requiring tooth extraction after radiotherapy for nasopharyngeal carcinoma (NPC) was studied retrospectively to determine the incidence of post-extraction complications. It was found that because of the method used in the delivery of radiation, extraction of maxillary posterior teeth resulted in the greatest risk of complications (28.9 per cent), including a 10.5 per cent risk of osteoradionecrosis (ORN). Based on the findings, a protocol was established for the dental care of such patients. It was concluded that when extraction of maxillary posterior teeth was necessary, prophylactic antibiotics were not sufficient to prevent the complication of delayed healing. The risk of ORN was 10.5 per cent within the field of maximal radiation dose. Hyperbaric oxygen may be the better choice of preventive measures. However, in view of the low risk of ORN, wholesale prescription of hyperbaric oxygen therapy may not be indicated. An additional patient who had tooth extraction two weeks prior to radiotherapy was included to show that if adequate time for wound healing was not allowed, ORN could develop.

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A treatment regime combining acupuncture, occlusal splint and point injection therapy for temporomandibular disorders (TMD) is presented. There were 89 consecutive patients treated by the regime in this case series but four patients dropped out after two to three visits. Data and treatment results of the remaining 85 patients who had treatment completed were analysed. It was found that 73 (85%) of patients with TMD had symptoms relieved within six visits under this regime. Complications were rare and minor. Acupuncture treatment, in combination with splint therapy and point injection therapy, appears to be effective for managing TMD. However, further research, using randomised controlled trials should be conducted to ascertain its effectiveness over other treatment modalities.

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