What it is
Radiation therapy saves lives — and sometimes leaves a slow-burning injury behind. Months or years later, irradiated tissue can break down: chronic bladder bleeding (radiation cystitis), rectal injury (proctitis), jaw bone death (osteoradionecrosis), non-healing wounds in the radiation field. The cause is the same everywhere: radiation progressively destroyed the small blood vessels.
How hyperbaric oxygen helps
This is one of HBOT's best-established uses. Repeated sessions don't just deliver oxygen — they signal the body to grow new blood vessels into the damaged field (the Marx protocol's core insight). Over 30–60 sessions, tissue oxygen levels measurably and durably rise, letting tissue that couldn't heal finally do so.
What treatment looks like
Typically 2.4 ATA for 90 minutes, 30–60 sessions. For tooth extractions or surgery in irradiated jaws, protocols split sessions before and after the procedure.
- Decades of clinical evidence; Medicare-covered.
- Ask about it before dental work on an irradiated jaw — prevention beats rescue.
The evidence, honestly
Grade A — Strong Evidence
Supported by randomized trials and/or decades of consistent clinical results.
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Hyperbaric oxygen treatment of chronic refractory radiation proctitis
International Journal of Radiation Oncology Biology Physics · 2008 · n=120 · rct
Double-blind randomized trial showing HBOT significantly improved healing responses in chronic refractory radiation proctitis versus sham.
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A new concept in the treatment of osteoradionecrosis
Journal of Oral and Maxillofacial Surgery · 1985 · n=268 · cohort
Established the protocol combining HBOT with surgery for osteoradionecrosis of the jaw, demonstrating markedly improved resolution versus antibiotics alone and defining the modern staged approach.
Common questions
My radiation was years ago — is it too late?
No. Radiation injury is about lost blood supply, and HBOT rebuilds it whenever it starts. Patients are treated successfully decades after their original radiation.
I need a tooth pulled after jaw radiation — why did my dentist mention HBOT?
Extractions in irradiated jaws can trigger osteoradionecrosis — bone that can't heal. A course of HBOT before and after the extraction dramatically lowers that risk. It's the standard of care, and your dentist is right to flag it.
Educational content, not medical advice — see our medical disclaimer. *Medicare coverage requires meeting clinical criteria; we verify yours for free. Last medically reviewed July 2026 by Dr. David Greene, MD.