Other signs and symptoms include:

Pain
Swelling
Non-healing sore or ulcer in the mouth
Trismus
An extra-oral fistula (from jaw to skin)
Infection in gums/teeth
Extra-oral draining sinuses
Lymphadenopathy
Malocclusion
Jaw fracture
Sequestrum (most commonly found below the mandible)If symptoms are evident, these should be reported to the patients doctor or healthcare team as soon as possible. Epidemiology and etiology
Epidemiology
The epidemiology of osteoradionecrosis has proven difficult to estimate, with previous studies reporting incidence of disease between 4.74-37.5%. More recent reports have estimated the incidence to 2%, which is likely attributable to improvements in radiation therapy. Pathophysiology
Radiation therapy destroys cancer primarily by causing DNA damage that promotes cell death. Tumor cells within a cancer are especially susceptible to damage by radiation as they frequently develop mutations in the DNA repair mechanisms that allow normal, healthy cells to recover from radiation damage. However, excessive radiation doses can cause even normal cells to be overwhelmed by DNA damage and lead to local tissue changes and necrosis. Scientists have been conducting investigations into the exact mechanisms of these changes to help create treatments since osteoradionecrosis (ORN) was first described by Regaud in 1922. Several competing theories have emerged over the years with resultant changes to accepted treatments. Initially, it was believed that ORN arose from a combination of radiation, trauma and infection. According to this belief, radiation damage to the bone caused the bone to weaken, making it susceptible to microfractures caused by trauma and allowing bacteria to invade. This theory placed ORN on a spectrum of disease with osteomyelitis, so it was primarily treated with antibiotics.
Antibiotics: In order to eliminate infection in the region, tetracyclines can be prescribed due to their selective uptake by bone. Penicillin antibiotics can also be used because of their superficial contamination with oral bacteria. Ultrasound therapy: First introduced as a treatment modality in 1992, it involves the application of high-frequency sound waves to induce angiogenesis and improve blood circulation to muscles. Harris demonstrated that 48% of cases showed healing when 15 minutes of ultrasound therapy was applied daily on the skin affected by ORN, while combined with debridement. Hyperbaric oxygen therapy (HBO): First described in 1973, HBO was intended to be an adjunctive treatment method in ORN. The theoretical basis behind this treatment was the fact that it causes an increase in tissue oxygen tension and an improvement in collagen synthesis, angiogenesis and epithelialization. However, its use as the only method in the management of ORN is controversial. There is little evidence to show any clinical benefit, and that it may not have therapeutical significance over a placebo. Surgical
Multidisciplinary approach (HBO + Surgery): Studies have shown support of combining HBO therapy and a surgical approach to treat ORN. This is in order to improve local blood circulation, with resection of necrotic bone and reconstruction with a free flap. However, some studies still state lack of benefit HBO therapy brings. It does not revive dead bone, therefore microvascular reconstruction without the use of HBO therapy is still a successful method of treating ORN.