Dental implants are increasingly prevalent in the head and neck cancer patient population and result in the creation of artifacts on CT imaging for treatment planning. In our practice, we have noticed more mucosal toxicity adjacent to dental implants and hypothesized that this observation may be due to errors in dose calculation. The purpose of this study was to retrospectively evaluate dosimetric differences in target coverage and organ at risk (OAR) sparing when adjusting for spurious CT measurements attributed to dental metal artifact. Nine patients with dental implants who were previously treated at our institution with definitive radiation for oropharyngeal cancer were selected for this retrospective study. All patients were treated with 6 MV photons using intensity modulated radiation therapy (IMRT). Dose calculation was performed using an algorithm with heterogeneity corrections. Dental implant and streak artifact volumes were contoured and new IMRT plans were generated with identical beam geometry and monitor units using the uncorrected reference CT data set and a corrected CT data set. Artifacts were assigned a soft tissue electron density value with a Hounsfield unit (HU) of zero. Using descriptive statistics, target volumes and OAR dosimetry were reported and compared between the clinical treatment plans and re-calculated plans. Target volumes analyzed were GTV (D95, D98, D99), intermediate-risk PTV (D95, D98, D99), and high-risk PTV (D95, D98, D99, D2cc). The maximum dose, Dmax, was also collected for each plan. OARs analyzed included the bilateral parotids (mean), oral uninvolved (mean), OAR pharynx (mean), mandible (max), and cord (max). The median artifact volume was 41.6 cc (range, 22.5 to 56.8 cc). When accounting for artifact error, there were small but statistically significant relative increases in Dmax (0.24%, P=.0273), mean oral uninvolved dose (0.24%, P=.0234), and mean left parotid dose (0.20%, P=.0469). On average, the hot spot (Dmax) increased by 181 cGy when accounting for artifact. There were no significant dosimetric differences between plans in terms of GTV, intermediate-risk PTV, and high-risk PTV coverage. There were no significant differences for the mandible max dose, cord max dose, OAR pharynx mean dose, or the right parotid mean dose. In this retrospective study, there was minimal dose variation to target volumes and OAR structures when substituting artifact with soft tissue density HUs. There were significant differences in terms of maximum dose and dose to the uninvolved oral cavity, which suggests that ignoring artifacts in CT images during planning may result in greater hot spots. While small, these differences are worthy of further study as they may at least partially contribute to increased rates of empirically observed mucosal toxicity in the vicinity of dental artifacts.