Bone Abstracts

Objective: With increasing usage of bisphosphonates and increasing longevity, many elderly patients are on long term bisphosphonates and may require some dental procedure. We wanted to determine the dental risk status based on Scottish guidance for Dental practitioners 2011.

Methods: An interviewer recorded information needed to classify risk status amongst a randomly selected database of bisphosphonate users.

Setting: Teaching hospital in United Kingdom.

Results: Age range 65–94 years, total number studied=100. 74% were females.

Seventy-eight percent users were at low risk (taking bisphosphonates for the prevention/management of osteoporosis. Twenty-two percent patients were at higher risk (previous diagnosis of BONJ, taking a bisphosphonate as part of the management of a malignant condition, Paget’s disease, osteogenesis imperfecta, systemic corticosteroids, immunosuppressants, coagulopathy, chemotherapy or radiotherapy) for development of rare condition Osteonecrosis of jaw.

Conclusions: This study shows that amongst bisphosphonate users, a significant proportion of elderly are at high risk of developing dental complications following invasive dental procedure. Risk assessment should be performed and documented as a routine in these patients. If any extraction or invasive dental procedure is deemed necessary then especially amongst high risk patients it should be carried out before commencement of bisphosphonate therapy.