Bone Abstracts

Objective: Good oral health is important for well being especially in the elderly. Osteonecrosis of Jaw is rare side effect of bisphosphonates and Denosumab. Patients need adequate dental precautions and appropriate advice from doctors and dentists to reduce the chance of this condition. Aim of the study was to assess the dental health of patients with osteoporotic fractures receiving bisphosphonate or denosumab treatments.

Methods: Single person administered Questionnaire study.

Subjects: Patients who had suffered fragility fracture and were receiving Bisphosphonate or Denosumab treatment.

Setting: Teaching hospital in United Kingdom.

Analysis: Responses were summarised and percentages calculated.

Results: Age range 65–94 years Females – 74%.

Number of patients studied – 100.

Sixty-six percent patients were registered with a Dentist. Reasons mentioned for those not registered were- not found necessary (30%), cost (35%) availability (35%). Sixty-eight percent visited their dentist twice or more within last 2 years. Sixty-four percent brushed their teeth daily. Eighteen percent had full or partial dentures. Seventy-four percent reported loose or sensitive teeth. Self reported dental health rating was- Good 32%, average 25% and bad 43%. Twenty-three percent had some dental procedure done within last 2 years. Fifty-five percent reported dental/gum infections in last 2 years.

Fifty-four percent reported medical/dental health professional informing side effects and precautions associated with osteoporosis drugs. Ten percent reported having discussion about BRONJ. Fifty-two percent had dental checkup done prior to initiating osteoporosis treatment.

Conclusions: This large study shows poor dental health is common amongst patients receiving osteoporosis treatments. There is a need to monitor, improve and maintain good oral health both by medical and dental professionals. All patients need information, education and advice about risks and benefits associated with osteoporosis therapies. Further large studies are needed to develop and validate a useful and practical Oral health assessment tool. We recommend that ‘oral health risk assessment’ should be integrated with ‘comprehensive Geriatric assessment tools’ for elderly patients.