Osteonecrosis of the jaw and bisphosphonates
BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c246 (Published 02 February 2010) Cite this as: BMJ 2010;340:c246All rapid responses
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Aliya Khan’s editorial deserves clarification with respect to its dental advice.1 The use of the broad term ‘dental procedure’ has the potential to cause confusion amongst the intended medical readership. There are multitudes of ‘dental procedures’ and many are perfectly safe in patients taking high dose bisphosphonates. Indeed, some ‘dental procedures’ in this group of patients, such as restorations or root canal therapy, are to be positively encouraged if the alternative is extraction of the tooth.2 A more accurate yet understandable term for interventions to be avoided in these patients might be ‘surgical procedures involving the mandibular or maxillary bone’. It would be unfortunate if doctors gave incorrect guidance to their patients as a result of misunderstanding the editorial.
1 Khan A. Osteonecrosis of the jaw and bisphosphonates. BMJ 2010;340:c246
2 Fedele S, Kumar N, Davies R, Fiske J, Greening S, Porter S. Dental management of patients at risk of osteochemonecrosis of the jaws: a critical review. Oral Dis 2009;15:527-537.
Competing interests:
None declared
Competing interests: No competing interests
Protocol required
I would like to emphasise the point that there should be a
written protocol(1)for all medical practitioners to refer all
patients to the Dental Practioner for making them dentally fit
before starting bisphosphonate treatment.
Patients should also be individually risk assessed by taking
their comprehensive dental history.
1. British Dental Journal (BDJ 2009; 207, 345)
Competing interests:
None declared
Competing interests: No competing interests