Dental Did You Know: The Protocol When Faced With Bisphosphonate-Related Osteonecrosis of the Jaw

Bisphosphonate drugs are used commonly in the orthopedic and oncology fields. One of the severe side effects is necrosis of the jaw, a difficult condition to treat. The author of this article recommends that general practitioners:

1. refer to an Oral Surgeon
2. chlorhexidine 0.12% rinses
3. appropriate pain control
4. treatment with antibiotics (Pen VK) due to the presence of Actinomyces (Clindamycin if allergic)
5. minimize any attempt to remove bony spicules
6. no attempt to manipulate soft tissue to cover the exposed bone

Source: Zosky J, Bisphosphonates or Other Drug-Induced Osteonecrosis of the Jaw, Oral Health, Vol 103, No 5, May 2013 pg 63-67.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100