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Prosthodontist care and dental rehabilitation after a maxillectomy | CION Cancer Clinics
After a maxillectomy a prosthodontist, a dentist trained to replace teeth and parts of the mouth, makes the obturator that closes the gap in the palate and carries new teeth. The work happens in stages, ideally starting before surgery, with several plates and adjustments as the mouth heals. This page explains the stages, the options, how radiotherapy changes things and what to ask. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What does a prosthodontist do after a maxillectomy?
- What are the stages of dental rehabilitation?
- What are the ways teeth can be replaced?
- What do the terms in your dental plan mean?
- How does radiotherapy change dental care?
- What do families believe about the plate and the teeth?
- What should you ask the prosthodontist?
- Common questions about dental rehabilitation after maxillectomy
The short answer
What does a prosthodontist do after a maxillectomy?
A prosthodontist is a dentist trained to replace missing teeth and missing parts of the mouth. After a maxillectomy they make the obturator, a removable plate that closes the gap in the roof of the mouth and carries replacement teeth, so you can eat and speak more normally.
Why they should be involved before surgery
The easiest time to plan is before the operation. The prosthodontist takes moulds of your mouth while the teeth and palate are still there, checks which teeth are healthy enough to keep, and talks to the surgeon about what will be removed. A tooth kept at the edge of the gap can make a real difference to how well the plate grips later.
What rehabilitation means here
It is not one appliance. It is a series of plates and adjustments over many months as the mouth heals and changes shape, followed by lifelong dental care. The aim is a mouth that is comfortable, closes off the nose from the mouth, and lets you chew, swallow and be understood.
Who this is not the whole answer for
If the gap was closed with a flap of tissue instead of a plate, you may still need a denture or implants to replace teeth, but not an obturator. The prosthodontist still has a role in that plan.
Step by step
What are the stages of dental rehabilitation?
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The visit before the operation
A full dental check, moulds of both jaws and often X-rays. Teeth that are badly decayed may be removed, especially if radiotherapy is likely afterwards, because extractions later are riskier.
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The surgical plate
Many teams fit a simple plate at the end of the operation. It holds the packing or dressing in place and lets you swallow and speak from the first days. It is usually fixed and removed by the team.
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The interim obturator
Once the first dressing comes out, a removable plate is made or the first one is relined. The mouth is still changing shape, so this plate is adjusted and relined several times, which is normal.
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The definitive obturator
When healing has settled, and after radiotherapy if you have it, a longer-lasting plate with better-looking teeth is made. Some people have the replacement teeth on implants at this stage.
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Reviews for life
The plate wears, the gums shrink and the fit loosens over time. Regular visits catch this early, along with decay in the teeth you still have.
Not sure whether this applies to you?
Ask an oncologistThe options
What are the ways teeth can be replaced?
The choice depends on how much bone was removed, how many teeth remain, radiotherapy and your general health. Ask your centre which of these it can offer.
An obturator with teeth
The plate that fills the gap also carries artificial teeth. It clips onto your remaining teeth and comes out for cleaning. It is the most common route and can be remade as the mouth changes.
Grip is harder when few or no upper teeth remain.Implant-supported plate
Titanium posts are placed in the remaining bone, and the plate clicks onto them. It is steadier for chewing and speech. When little bone is left, longer implants into the cheekbone are sometimes used.
Less likely to suit
- Bone that has had high-dose radiotherapy
- Heavy smokers
- Poorly controlled diabetes
A flap with a denture or implants
When the gap is closed with tissue or bone moved from elsewhere in the body, there is no hole to seal. Teeth are then replaced with a denture or implants placed into the new bone.
Fixed bridges on remaining teeth
For a small operation that takes only a few teeth and no opening into the nose, a bridge or partial denture on the nearby teeth may be enough.
Words you will hear
What do the terms in your dental plan mean?
- Obturator
- A removable plate that closes the gap between your mouth and your nose or sinus.
- Relining
- Adding new material to the fitting surface of the plate so it matches the changed shape of your healing mouth.
- Maxillofacial prosthodontist
- A prosthodontist with extra training in replacing parts of the face and jaw after cancer surgery or injury.
- Osseointegration
- The process by which bone grows onto an implant and holds it firmly.
- Osteoradionecrosis
- Jaw bone that fails to heal after radiotherapy, often after a tooth is pulled. It is why dental work is planned carefully around radiation.
- Trismus
- Stiffness of the jaw muscles that makes it hard to open the mouth wide, which can make fitting a plate harder.
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If radiotherapy is planned
How does radiotherapy change dental care?
Radiotherapy to the upper jaw affects the teeth, the saliva and the bone, and those effects last. Dental care is planned around it, which is why the dental check happens before treatment starts rather than after.
Dry mouth and decay
Saliva protects teeth. When radiotherapy reduces it, decay can spread quickly, often at the gum line. You may be given fluoride gel or trays to use at home and asked to come for check-ups more often. Sipping water and avoiding sugary drinks between meals helps.
Why a tooth pulled later is a bigger decision
Bone that has had radiotherapy heals poorly. Pulling a tooth from it can leave bone exposed that does not close over. Tell any dentist you see, for the rest of your life, that you have had radiotherapy to the jaw, and let them speak to your cancer team before any extraction.
Jaw stiffness
Radiotherapy and scarring can stiffen the jaw. Daily mouth-opening exercises taught by your team help keep enough opening to take the plate in and out.
Commonly believed
What do families believe about the plate and the teeth?
"The first plate is the final one, so it should fit perfectly."
The mouth keeps changing shape for months after surgery. Early plates are expected to loosen and need relining. A plate that rubs or leaks is a reason to return, not a sign that something has gone wrong.
"Any dentist near home can make the obturator."
A general dentist can look after your remaining teeth, but an obturator after cancer surgery is specialised work. Ask your surgical team to refer you to a prosthodontist with experience after maxillectomy. The first stages are usually best done where the surgery was.
"Implants are always better than a removable plate."
Implants can make a plate steadier, but they need enough healthy bone, good healing and extra surgery. After radiotherapy the risk of problems is higher. For many people a well-made removable plate is the more sensible choice.
"With false teeth in, the remaining teeth need less care."
The opposite is true. The remaining teeth hold the plate in place, and losing one can loosen the fit. They need more careful brushing and more frequent dental visits, particularly if you have had radiotherapy.
Before surgery
What should you ask the prosthodontist?
Your question
Why it matters
Will I see you before the operation?
Moulds and tooth planning are far easier before surgery
Which of my teeth can be kept?
Teeth next to the gap often decide how well the plate grips
How many plates and visits should I expect?
Lets your family plan travel and time off work
Are implants possible for me, and what stops them?
Bone, radiotherapy and health all change the answer
Which parts are covered by my scheme or insurance?
Dental and prosthetic work is often billed separately
Questions we are asked
Common questions about dental rehabilitation after maxillectomy
Will I wake up from surgery with a hole in my mouth?
Usually not an open one. Many teams place a surgical plate or packing at the end of the operation to cover the gap, so you can swallow and speak in the first days. Ask your surgeon before the operation what will be in place when you wake up.
How long before I get teeth back?
Some people have a plate with a few teeth early on, others wait until healing and radiotherapy are finished. The longer-lasting plate comes after the mouth has settled. Your prosthodontist can give you a rough plan once the pathology and treatment plan are known.
Can I eat normally with an obturator?
Most people eat a soft diet at first and slowly widen it as the fit improves. Chewing is usually easier on the side that was not operated on. Hard or sticky foods can dislodge the plate, so a dietitian can help you keep nutrition up while you adjust.
Should I sleep with the plate in?
Your team will tell you. Early on some people are asked to keep it in so the tissues do not shrink around the gap. Later, many take it out at night to rest the gums and clean it. Follow the instruction given for your stage of healing.
Why does my voice sound nasal when the plate is out?
Without the plate, air escapes into the nose while you speak, which makes speech sound nasal and harder to understand. With a well-fitting plate it usually improves a great deal. If it stays nasal with the plate in, the seal may need adjusting.
Is dental rehabilitation covered by Aarogyasri or insurance?
It varies. The surgical plate is often part of the operation package, while later plates and implants may not be. Aarogyasri, CGHS, ECHS, EHS and cashless insurers each have their own rules. Ask for the dental part of the plan to be estimated separately in writing.
Can I get the obturator made closer to home in my district?
Later adjustments sometimes can be, if a trained prosthodontist is available nearby. The early plates are usually made where the surgery happened, because the surgeon and prosthodontist need to work together. Ask your team whether they know someone closer who can take over reviews.
What if the plate hurts or causes a sore?
Do not file it or bend it yourself. Take it back to the prosthodontist, who can adjust the pressure point. A sore that does not heal, or a new lump or ulcer near the plate, should be shown to your surgical team too, not only the dentist.
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Sources
- National Cancer Institute — Paranasal Sinus and Nasal Cavity Cancer Treatment (PDQ) - Patient Version
- American Cancer Society — Surgery for Nasal Cavity and Paranasal Sinus Cancer
- Cancer Research UK — Surgery for mouth cancer
- Macmillan Cancer Support — Head and neck cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Obturators: The Removable Plate That Seals the PalateHow the plate is built and how it sealsFlap Reconstruction vs ObturatorHow the choice between a plate and a flap is madeSpeech After MaxillectomyHow the plate changes the way you soundMaxillectomy Cost in HyderabadWhere the dental work sits in the bill
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