Dental interventions in patients taking anti-resorptive medication for the treatment of osteoporosis and other bone disease: an audit of current practice in the Dublin Dental University Hospital

Abstract

Medication-related osteonecrosis of the jaws (MRONJ) is a well-established complication of anti-resorptive and, more recently, anti-angiogenic therapy. The dental profession has a pivotal role to play in the prevention and management of this debilitating condition, and all dentists have a responsibility to remain cognisant of national and international best practice guidelines in the prevention of this disease process. The management of patients in the Dublin Dental University Hospital at risk of MRONJ when carrying out dental interventions was audited against nationally- and internationally-published guidelines. The results of the audit showed compliance with the national and international guidance in 5% and 0% of cases, respectively. The most common measures implemented in the management of patients at risk of MRONJ were: preoperative antibiotics in 49% of cases; preoperative chlorhexidine mouthwash in 76%; plain local anaesthetic in 51%; and, post-operative antibiotics in 80%.