Are you confident in managing patients on bisphosphonates or biologics?

Which medications increase the risk of medication-related osteonecrosis of the jaw (MRONJ)?

How do you decide when to extract a tooth and when to refer to a specialist?

In this episode, Jaz is joined by oral surgery consultant Dr. Pippa Cullingham to explore the complexities of MRONJ. They break down the key risk factors, share expert advice on when to proceed with extractions, and discuss the latest guidelines for managing patients at risk.

They also discuss the importance of early assessment - by identifying at-risk teeth early, you can help prevent serious complications and ensure the best outcome for your patients.

Protrusive Dental Pearl: it is so important to assess patients before they start taking high-risk medications like bisphosphonates or biologics, using radiographs to identify potential issues. Extractions should ideally be done before medication starts to avoid complications, as MRONJ risk increases once treatment begins.

Key Takeaways:
Medication-related osteonecrosis of the jaw concerns medications other than bisphosphonates.
Risk assessment is crucial when considering dental extractions for patients on certain medications.
Guidelines from the Scottish Dental Clinical Effectiveness Partnership are valuable resources for dentists.
Higher-risk patients require careful management and communication with their medical teams.
Denosumab has a different risk profile compared to bisphosphonates.
Patients on long-term bisphosphonates may still have risks even after stopping the medication.
Dentists should feel empowered to manage certain extractions in primary care with proper guidance.
The decision to extract a tooth should weigh the risks and benefits for the patient.
Always assess the patient's risk before extraction.
Eight weeks is a critical time for assessing healing.
Antibiotics are not recommended for preventing MRONJ in the UK.
Radiotherapy history significantly impacts extraction risk.
Referral to specialists may be necessary for high-risk patients.