HBO and ORN/tooth extraction

I have a patient who completed HBO for ORN #31 last April. His oncologist is requesting 10 additional dives due to patient having a tooth #31 extraction scheduled. There is a 10mm dept surrounding the tooth. Do you think it is appropriate to continue with the additional 10 dives? Would this be considered medically necessary given the timeframe in between dives?

Apr 19, 2023 by Decendar Hart,

1 replies

Eugene Worth
MD, M.Ed., FABA, ABPM/UHM

Great question! This comes up frequently, and I have had the opportunity to talk with Bob Marx (of the Marx protocol) about this question. He pointed me to a diagram of his own research that showed TcPO2 on the Y axis and time/number of treatments on the X axis. The TcPO2 remains about 80% of normal for years after completing a full treatment table of HBOT. He did not recommend treatment with HBOT for simple extractions and/or minor bony debridement. If there is trouble healing the extraction site, another debridement and HBOT for 10 postoperatively should be considered.

So, in my practice, I would not treat this patient for this dental procedure.

Apr 19, 2023

* Information provided without clinical evaluation and is not intended as a replacement for in-person consultation with a medical professional. The information provided through Curbside Consult is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.

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