What are risk factors for developing osteoradionecrosis of the jaw?

There are several risk factors that contribute to the development of osteoradionecrosis of the jaw. Osteoradionecrosis may be referred to as bone death and can be a serious complication following treatment of head and neck cancer.  

 These risk factors include:

1. Patients who endure high doses of radiation of 60 Grays or more to the nasopharynx, oropharynx, and oral cavity.
2. Patients who undergo chemotherapy increases acute toxicity, especially oral mucositis, which can lead to oral ulcers and tissue breakdown.
3. Patients who undergo ablative surgical procedures and then receive radiotherapy.
4. Patients who have large tumors near or on the mandible.
5. Patients who have weakened immunologic health, nutritional status, and lower BMI.
6. Patients who have poor dental hygiene and have had recent dental extraction post- radiotherapy.
7. Patients who are positive for tobacco and alcohol use during and after radiotherapy.
8. Patients who are treated with anti-resorptive agents for osteoporosis such as intravenous, high-potency bisphosphonates and denosumab.