Patients on bisphosphonates

[toothdental52]

---

Members don't see this ad.

Perform SRP for patients on bisphosphonates or get clearance from medical doctor?

 

[Screwtape]

You probably know more about bisphosphonates and dental treatment than the medical doc. I would look at the literature but as far as I know SRP is ok.

 

[omfsing]

Perform SRP for patients on bisphosphonates or get clearance from medical doctor?

I agree with screwtape. Medically clearance won't cover you here. Mronj, though low risk, can still occur after srp if alveolar bone is traumatized (again low risk). Much of this deals with oral vs IV bisphosphanate use. Also, if pt is on oral bisphosphanates you need to consider for how long patient has been on the meds, which will determine a drug holiday

You can find more info here

https://www.aaoms.org/docs/govt_affairs/advocacy_white_papers/mronj_position_paper.pdf

 

[vellnueve]

You're not putting someone on a drug holiday for a frigging cleaning.

OP, look at some actual literature rather than seeking advice on a message board.

 

[The Anhedonia]

Make sure you have an excellent informed consent for the patient. IV bisphosphonates pose greater risk of MRONJ than PO, and though unlikely from an SRP, the patient should be adequately informed of the risks/benefits/alternatives.

 

[Localnative]

I agree with screwtape. Medically clearance won't cover you here. Mronj, though low risk, can still occur after srp if alveolar bone is traumatized (again low risk). Much of this deals with oral vs IV bisphosphanate use. Also, if pt is on oral bisphosphanates you need to consider for how long patient has been on the meds, which will determine a drug holiday

You can find more info here

https://www.aaoms.org/docs/govt_affairs/advocacy_white_papers/mronj_position_paper.pdf

Drug holiday = pointless given long ass T1/2 of the drugs
Go to dds4dds.com for good pt consent for treatment

 

[knife]

no risk of MRONJ with cleanings and deep cleanings, unless a flap procedure is indicated. That is, if perio surgery is involved then you are at risk. Regular cleanings and SRP.. no worries. I see 1-2 MRONJ consults/day in my cancer center currently and this is the guideline we follow

 

[toothdental52]

no risk of MRONJ with cleanings and deep cleanings, unless a flap procedure is indicated. That is, if perio surgery is involved then you are at risk. Regular cleanings and SRP.. no worries. I see 1-2 MRONJ consults/day in my cancer center currently and this is the guideline we follow

thank you all