When a patient is diagnosed with head and neck cancer, the path to treatment requires careful coordination across disciplines. At the University of Colorado Anschutz, dentistry is not peripheral to that process — it is an essential clinical partner in ensuring safe and effective cancer care.
At the CU Anschutz School of Dental Medicine, this integration is being advanced through a structured, collaborative approach to pre-radiation dental clearance, led by Petros Yoon, DDS ’15, assistant professor in the Department of Diagnostic Sciences and Surgical Dentistry and Director of Intake and Care Referral. Working in close partnership with Ryan Lanning, MD, PhD, associate professor in the Department of Radiation Oncology at the CU School of Medicine and UCHealth, Dr. Yoon helps coordinate a system that aligns dental evaluation with the urgency and complexity of oncology treatment.
“We recommend dental clearance for every head and neck cancer patient,” Dr. Yoon said, reflecting a standard of care that prioritizes both immediate safety and long-term outcomes.
For patients undergoing radiation therapy to the head and neck, dental clearance is a vital component of treatment planning. Its purpose is to reduce the risk of complications that can arise when compromised oral health intersects with radiation-induced tissue changes.
Foremost among these concerns is osteoradionecrosis (ORN), a condition in which irradiated bone loses its ability to heal. After radiation, even routine dental extractions can lead to non-healing wounds, exposed bone and chronic infection.
To mitigate this risk, the dental team works to eliminate active and likely sources of infection before radiation begins. This includes:
The goal is to preserve dentition whenever possible while proactively managing conditions that could lead to complications later. Decisions often involve balancing ideal dental care against the realities of a narrow treatment window.
Dental clearance is typically completed several weeks before radiation planning. This compressed timeline can limit more complex interventions, requiring the dental and oncology teams to carefully weigh risks, ensuring that cancer treatment proceeds without delay while minimizing future oral health complications.
Together, Dr. Yoon and Dr. Lanning designed a structured referral and clearance system that now serves patients from the CU Anschutz Cancer Center and other UCHealth sites:
The workflow is built to support community dentists. Dr. Yoon noted, “We prioritize working with a patient’s established dentist whenever possible, allowing them to complete the clearance and maintain continuity of care.”
For patients who come through the cancer center without a dental home, many choose to remain within the Anschutz ecosystem after their clearance, establishing ongoing care in the Dental Faculty Practice.
This collaborative approach ensures that decisions are not made in isolation, but as part of a coordinated effort across disciplines, for the benefit of the patient.
While the current workflow focuses on pre‑radiation dental clearance for head and neck cancer, the same principles apply to other medically complex scenarios.
Dr. Yoon’s background positions him uniquely for this work. After completing a general practice residency at UNC Chapel Hill, where he routinely managed hospital‑based clearances for cardiac, transplant and radiation patients, he practiced in a rural Salud clinic in Sterling, Colorado, continuing to collaborate with a local radiation oncologist. He later completed oral medicine training at Harvard School of Dental Medicine, working on an oral oncology service that managed the oral side effects of chemotherapy, immunotherapy and radiation.
Yet he is clear that this is not a niche reserved only for specialists.
“You don’t have to be an oral medicine specialist to complete radiation dental clearances,” he emphasized. “Our general dentists in the community can help. That’s why we created a standardized process documentation to share.”
The role of dental medicine extends beyond the completion of dental clearance. Radiation-induced changes, including xerostomia (dry mouth), increased caries risk and reduced jaw mobility, require ongoing management to protect oral health and quality of life.
To support patients, Dr. Yoon emphasizes preventive strategies, including:
“These are lifelong considerations,” he said, emphasizing the importance of preserving teeth and avoiding invasive procedures after radiation whenever possible.
The collaborative model at CU Anschutz demonstrates how structured workflows, strong partnerships and patient‑centered education can transform what was once an ad-hoc process into a reliable standard of care. By embedding dentistry within the cancer team through the collaboration of Dr. Yoon and Dr. Lanning, the campus is not only protecting patients today but also creating a blueprint that can be shared with other centers and community practices.