Do I Have Osteoradionecrosis? Signs, Risk Factors, and When to Seek Help
Radiation therapy saves lives. But for some head and neck cancer survivors, it can leave behind long-term complications, including a painful and often misunderstood condition called osteoradionecrosis (ORN).
If you’re experiencing ongoing jaw pain, visible bone in your mouth, or non-healing sores after cancer treatment, you may be wondering: Is this normal, or something more serious?
This blog will help you understand what ORN is, recognize the signs early, and know when to seek care from a specialist.
What Is Osteoradionecrosis (ORN)?
Osteoradionecrosis is a condition where bone tissue, most commonly in the jaw, dies as a result of radiation therapy. Radiation can damage small blood vessels and reduce circulation in the area, leaving the bone starved of oxygen and unable to repair itself. This leads to bone breakdown, infection risk, and long-term complications.
Why it Matters:
Without treatment, ORN can significantly impact quality of life. It can cause chronic pain, difficulty eating or speaking, jaw instability, and even increase the risk of jaw fractures or infections.
The good news? When caught early and treated with advanced therapies, such as hyperbaric oxygen therapy (HBOT), outcomes of ORN improve significantly.
5 Warning Signs You May Have Osteoradionecrosis
It’s easy to overlook symptoms of ORN, especially if you’ve already been through cancer treatment and recovery. However, ignoring these signs can delay healing and exacerbate the issue.
Look out for the following red flags:
1. Persistent Jaw Pain or Stiffness
Pain that lingers for weeks or months, especially in previously irradiated areas of the jaw.
2. Non-Healing Mouth Ulcers
Sores inside the mouth or along the gumline that don’t close after 2–3 weeks, even with good hygiene.
3. Exposed Bone
You may notice a white, rough, or sharp area of bone visible through the gum or inner cheek.
4. Swelling or Drainage
The soft tissue around the site may become red, swollen, or start to drain pus or develop a foul odor.
5. Difficulty with Dentures, Chewing, or Speaking
If wearing dentures becomes painful or you’re experiencing
Who’s Most at Risk for ORN?
Osteoradionecrosis doesn’t happen to everyone who’s received radiation, but certain factors increase the likelihood.
You may be at higher risk if:
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You received high-dose radiation (typically over 60 Gy) to the head or neck
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You’ve had recent dental extractions or trauma in irradiated areas
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You use dentures that place pressure on your jaw
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You have underlying conditions like diabetes or vascular disease
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You smoke or have poor post-treatment oral hygiene
It’s also more common in the mandible (lower jaw) than the maxilla (upper jaw), due to its denser bone and more limited blood supply.
Why Early Diagnosis is So Important
ORN is a progressive condition, the longer it’s left untreated, the worse it can get. If caught early, many cases can be managed without surgery, using advanced therapies like hyperbaric oxygen therapy (HBOT) to improve blood flow and support healing.
Early intervention can:
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Prevent further bone loss
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Reduce pain and inflammation
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Help tissue respond better to antibiotics or surgery
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Preserve jaw function and appearance
Don’t wait for symptoms to worsen. If you’re noticing any of the signs above, a wound care consultation could make all the difference.
How Hill Country Wound Care Treats ORN
At Hill Country Wound Care & Hyperbarics, we offer physician-led, outpatient hyperbaric oxygen therapy (HBOT) as part of a comprehensive treatment plan for osteoradionecrosis in San Antonio.
How HBOT Helps:
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Delivers 10–15× more oxygen to damaged tissue
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Promotes new blood vessel growth (angiogenesis)
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Reduces scarring and improves circulation
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Prepares bone for surgery or helps avoid surgery altogether
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Many Patients have reported an improvement in pain and function after 10–15 sessions.
We work closely with your oral surgeon, dentist, and oncologist to ensure that your treatment plan is safe, effective, and tailored to your specific case.
Learn more about our approach in the Ultimate Guide to Hyperbaric Oxygen Therapy for Osteoradionecrosis.
Why Hill Country Wound Care & Hyperbarics?
We offer a patient-first approach to advanced wound healing that prioritizes comfort, convenience, and results:
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Three Clinic Locations in San Antonio: North, East, and Southwest, with free parking and easy access
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Physician-Led Care: Our hyperbaric team includes board-certified doctors who are on-site and hands-on
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Advanced Technology: We use FDA-approved protocols and leading HBOT equipment
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Insurance-Friendly Options: Medicare and most private insurance are accepted. Check here for our full list!
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Compassionate Support: We guide you through pressure changes, treatment planning, and paperwork
When Should You Call Us?
If you’ve undergone head or neck radiation and are experiencing:
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Jaw pain that’s worsening or persistent
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Bone exposure in your mouth
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Sores that haven’t healed in 2+ weeks
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Difficulty eating, speaking, or using dental appliances
…it’s time to talk to a specialist. At Hill Country, we’ll evaluate your symptoms, coordinate with your care team, and determine whether HBOT can help you heal.
Real Hope for Healing
ORN can feel scary, but you don’t have to navigate it alone. With early intervention and the right care plan, recovery is possible.
At Hill Country Wound Care & Hyperbarics, we’re proud to help head and neck cancer survivors heal faster, live better, and preserve their quality of life.
Serving San Antonio at three convenient outpatient clinics
Led by board-certified hyperbaric physicians
Accepted by Medicare and most private insurance plans
If you’re worried about your jaw health after radiation, take the next step with a team that understands ORN and how to treat it effectively.