John, For what it's worth, my oral surgeon, who has a lot of experience treating patients who have had oral radiaton, says some of his patients who have had oral radiation choose to have oral surgery such as tooth extractions without Hyperbaric oxygen therapy (HBO) and take their chances with ORN, especially if he believes their risk is low because of their radiation plan (apparently with IMRT radiation, less of the jaw is likely to be severly damaged by radiation than with general field radiation). I think this is in part because anyone living here would have to drive oevr an hour each way to GET HBO and you have to go every day for several weeks of treatment. He says often they don't have a problem, but once in a while they do.

Apparently the standard the recommendation is that you have a certain number of HBO therapy sessions before any surgery that affects the jaw (O'm thinking he said 30 but I'm not at all sure I'm recalling that right) and then a few more after in order to be sure the jaw is going to heal OK.

It also apparently helps heal soft tissue that may be permanently injured from radiation. There are other folks here who can say more about that.

Nelie