My RO told me that ORN is a lifelong issue. I kept all of my teeth. I used dental trays with prescription flouride every week for years and get my teeth cleaned every 3 months. There was a slight receding of the gums but they remain healthy. I have had a few minor filing repairs and one porelain filing in a molar in the radiation field. The dentist tells me my teeth and gums are in better shape than many of his other patients. I would still need HBO for any extractions, especially in the radiation field (or any area receiving over 62 cGy). I had IMRT and still use Biotene. I also use woven floss which is much easier on the gums.