Post-radiotherapy
Patients will still be susceptible to radiation caries and periodontal disease, more so if they present with dry mouth or access difficulty when tooth brushing. Any restorative or periodontal procedures should be commenced if indicated and endodontic treatments should take priority over extractions, although if there is a difficulty in mouth opening, endodontic treatments can be difficult or impossible. Where a tooth is deemed unrestorable, decoronation can be done. Although dentures should be avoided if a shortened dental arch is manageable, if a denture is required or being used, they should be checked routinely and any adjustment to pressure areas should be made to avoid ORN secondary to denture trauma. Extractions post-radiotherapy
A practical recommendation  is provided in some case where it is necessary to extract teeth from the jaw after radiotherapy. An assessment of the risk of ORN should be done based on the dose of radiation, the site and how easy is the extraction. Any information on risk and early signs of ORN should be given to the patient. The recommendations are listed below, however, there are some controversies on the ideal antibiotic regime and the use of hyperbaric oxygen therapy (HBO).Summary of recommendations:
0.2% chlorhexidine mouthrinse given before extraction
Oral antibiotics(3g) given 1 hour prior to extraction ( if allergic 600 mg clindamycin)
Amoxicillin 250 mg 3 times/day or metronidazole 200 mg 3 times/day for 3–5 days post-operatively.
following a biopsy in the mouth
Kawasaki disease,
Kikuchi-Fujimoto disease
Rosai-Dorfman disease
Castleman disease
Sarcoidosis
Lupus erythematosus
Cyclic neutropenia
Orofacial granulomatosis

Diagnosis
In possible malignancy, it is routine to perform a throat examination including mirror and/or endoscopy.On ultrasound, B-mode imaging depicts lymph node morphology, whilst power Doppler can assess the vascular pattern. B-mode imaging features that can distinguish metastasis and lymphoma include size, shape, calcification, loss of hilar architecture, as well as intranodal necrosis. Soft tissue edema and nodal matting on B-mode imaging suggests tuberculous cervical lymphadenitis or previous radiation therapy. Serial monitoring of nodal size and vascularity are useful in assessing treatment response.Fine needle aspiration cytology (FNAC) has a sensitivity and specificity percentages of 81% and 100%, respectively, in the histopathology of malignant cervical lymphadenopathy. PET-CT has proven to be helpful in identifying occult primary carcinomas of the head and neck, especially when applied as a guiding tool prior to panendoscopy, and may induce treatment related clinical decisions in up to 60% of cases. == References ==