Awareness of medical doctor on medication-related osteonecrosis of the jaw in osteoporosis patients

Abstract

Antiresorptive drugs are widely used to treat osteoporosis. A serious adverse effect of these drugs is medication-related osteonecrosis of the jaw (MRONJ). By informing and educating patients about MRONJ, providing proper dental referral, and monitoring the oral health of patients who receive antiresorptive agents, physicians can reduce the risk of MRONJ. We investigated the awareness and clinical practices of physicians in Thailand with regard to MRONJ. Physicians who prescribed antiresorptive drugs for osteoporosis filled out an online self-administered questionnaire about demographic characteristics, awareness, and practices related to MRONJ. Most respondents agreed that antiresorptive drugs may cause MRONJ (92.3%), that poor oral health increased the risk of MRONJ (84%), and that MRONJ is an important consideration in patients with osteoporosis (85%). Of the respondents, 48.1% and 15.5% always referred patients to dentists before and during antiresorptive therapy, respectively; the majority, however, referred only patients considered at risk for MRONJ. Approximately 60% informed patients of the risk for MRONJ before antiresorptive therapy began, and 30% inquired about patients’ oral symptoms at the follow-up visit after antiresorptive therapy began. Forty-four percent advised patients to receive oral health care; the most common reason for not advising this was that respondents did not consider themselves knowledgeable enough to detect oral health problems. Most respondents were aware of MRONJ and accounted for it in their practice; many, however, did little to prevent MRONJ. Physicians prescribing antiresorptive drugs should adhere to clinical practice guidelines for reducing the risk of MRONJ.