Which statement best describes the appropriate approach when a patient on bisphosphonates requires dental surgery?

Which statement best describes the appropriate approach when a patient on bisphosphonates requires dental surgery?

• A. Coordinate with physician and consider conservative treatment.
• B. Ignore medical therapy.
• C. Proceed with full invasive plan.
• D. Discontinue all dental care.

Answer: (A)

When a patient is taking bisphosphonates, the main issue in dental surgery is the potential disruption of bone healing, which can lead to medication-related osteonecrosis of the jaw. Because of this, the safest and most effective approach is to collaborate with the patient’s physician to assess risk and choose a treatment plan that minimizes invasiveness. This often means prioritizing conservative, non-surgical or minimally invasive options and delaying or altering procedures whenever possible in consultation with the prescriber. If an operation is unavoidable, plan it with atraumatic technique, consider alternatives to extraction if feasible, and ensure close postoperative monitoring with appropriate infection control measures. This approach is best because it directly addresses the systemic risk from bisphosphonates while still meeting the patient’s dental needs, rather than ignoring therapy, performing a full invasive plan, or discontinuing care altogether.

When a patient is taking bisphosphonates, the main issue in dental surgery is the potential disruption of bone healing, which can lead to medication-related osteonecrosis of the jaw. Because of this, the safest and most effective approach is to collaborate with the patient’s physician to assess risk and choose a treatment plan that minimizes invasiveness. This often means prioritizing conservative, non-surgical or minimally invasive options and delaying or altering procedures whenever possible in consultation with the prescriber. If an operation is unavoidable, plan it with atraumatic technique, consider alternatives to extraction if feasible, and ensure close postoperative monitoring with appropriate infection control measures.

This approach is best because it directly addresses the systemic risk from bisphosphonates while still meeting the patient’s dental needs, rather than ignoring therapy, performing a full invasive plan, or discontinuing care altogether.