To start I am 11 years post radiation this year. I had 1/3 of my tongue removed and the teeth on that side of my mouth have started to 'fall in' (for lack of a better term) which has caused my front teeth to push together as well as one tooth that's being pushed up. I'm considering Invisalign and neither my dentist or ortho seem to think it's an issue that I've had radiation however I'm in a new city with doctors that aren't as familiar with what I've been through as my doctors in Phoenix. I've yet to find anyone who has had orthodontia done post radiation that can give me feedback.

My dentist did say that having all 4 of my wisdom teeth removed within the first 2 years post radiation (also did HBOT) was likely more serious than orthodontia but I just want to be careful and make an informed decision. Thanks in advance.

Having been on faculty in an Orthodontic dept at a dental school, I would question the status of your bones. moving teeth requires bone to dissolve and slowly regrow if teeth are being moved around.

best wishes

My personal opinion is this is not a good idea. You’d be the first person out of thousands I’ve dealt with that I have heard considering this. Doing anything that involves radiated bone is risky for not healing properly or triggering ORN or other negative issues. While some may argue that this is a function of field of radiation and GY exposure, these dentists don’t know any of that. There are no other bone quality tests that can be done. This is all related to the loss of microvascularization in the bone from radiation which they are not going to see on x rays.

Orthodontic movement involves pressure die back of bone on one side and new bone growth on the other to granulate into the void. Radiated bone is not going to behave like normal bone and like young bone where it is the most adaptable.

If they are so confident, ask them if they are willing to accept the liability for damage to your bone if this all goes south. Note that for you and them that liability could be a fibula free flap surgery if ORN is an outcome of this idea.