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Bisphosphonate recommendations updated

The ADA Council on Scientific Affairs has updated its recommendations for managing patients on oral bisphosphonate therapy.

The council originally released the recommendations in July 2006.

In this new re-evaluation of the evidence, the CSA determined that the incidence of bisphosphonate-associated osteonecrosis of the jaw (BON) remains very low and also concluded that no reliable screening or diagnostic tests are currently available to predict a patient's risk to develop this condition.

On the diagnostic testing the council stated: "Therefore, while the expert panel recognized the value of predicting and mitigating the risk for developing BON in individual patients, until objective research studies document and correlate specificity, predictive value and reliability of such tests, no recommendations for their use can be made."

Dr. Peter Jacobsen, CSA vice chair, added, "As professionals and clinicians we need to realize that expert opinion is only as good as the information available at the time. Our understanding of the effects of bisphosphonates on jaw bone is evolving and, as the new information about mechanism, risk factors, predictive criteria and treatment evolve, expert opinion on the best management practices will also evolve. Adjusting patient management, based on new information and techniques, will always be an ongoing responsibility for all dental professionals."

Although the risk of developing BON while taking oral bisphosphonates is very small, dentists are advised to consult the updated recommendations and to be prepared to discuss the potential risks and benefits of dental care for their patients who are taking oral bisphosphonates. Given the risks associated with osteoporosis and the proven benefits of oral bisphosphonate therapy, the physician and patient should fully discuss any decision to alter the use of these medications. The recommendations are intended to assist dentists in maintaining good communication with not only their patients but the patient's physicians as well.

To see the recommendations online visit ADA.org or call the ADA toll-free, Ext. 2878.