FROM THE DESK OF ALAN M MELTZER DMD MScD
UPDATE #2 ON BISPHOSPHONATE-ASSOCIATED
OSTEONECROSIS OF THE JAW (ONJ)
How should a dentist manage a patient receiving IV bisphosphonate therapy?
- Management should be by a qualified dental specialist.
- Pain management as required.
- Report case to all appropriate authorities.
- Management of infection
- Oral antimicrobial rinses (0.12% Chlorhexidine).
- Systemic antibiotics as required.
- Surgical management.
- Conservative or delayed.
- Remove sharp exposed bone edges.
- Bone sequestra should be removed without exposing uninvolved bone.
- Dietary supplements to fulfill nutritional needs.
- Controversial additional options.
- Stop bisphosphonates.
- Hyperbaric oxygen.