Salivary gland impairment after radioiodine therapy (RIT) is a well-known iatrogenic artifact that includes recurrent episodes of sialadenitis, hyposalivation, dysgeusia, and dysphagia. Several therapy modalities have been suggested over the years to decrease these effects on the salivary glands. However, in cases where the salivary gland system is impaired prior to RIT, preserving its function becomes more challenging. We present three patients who underwent RIT with pre-existing insult to the salivary glands and discuss the treatment modality employed. A protocol for treating patients with pre-existing salivary gland impairment prior to RIT is proposed. The dental professional personnel should be aware of RIT insult to the salivary glands in order to preserve more maliciously the oral health in these patients. Management of impaired salivary glands subjected to additional RIT is mandatory to reduce further damage to the glands' function primarily by combining interventional sialoendoscopy for recurrent sialadenitis and sialogogues for hyposalivation. Keywords: iodine therapy, saliva, salivary glands, sialoendoscopy, Sjogren's syndrome