Will you wait to simulate, or resimulate, a patient after teeth extractions in preparation for HN cancer treatment?

The answer is, it depends.

I do not have a specific policy, and it depends refers to which and how many teeth need to be extracted.

The main questions to answer this question are:

1. Will the extractions alter the set up?
2. And as a corollary, will the extractions alter the use of an intraoral device?
3. A...

If the patient has dental extractions done between initial RT simulation and RT start date, I rely on the cone beam CT done during the first fraction to decide whether or not I need to do a re-simulation.

In case the anatomy is lining up well on the CBCT, which is usually the case, I go ahead with R...

If the extractions are extensive, I typically wait.

But in a practical sense, it's often not until the patient has been seen by dentistry/oral surgery before I know what the extent will be, so I wait more often than not so as to ensure as reproducible a setup as possible.