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: Will the extractions alter the set up? And as a corollary, will the extractions alter the use of an intraoral devi...

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 ...

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.