Bisphosphonates Alert

The Australian Adverse Drug Reactions Bulletin (Volume 25, Number 4, August 2006) contains an alert prepared by the Adverse Drug Reactions Advisory Committee (ADRAC) regarding Osteonecrosis of the jaw with bisphosphonates.

The alert notes that "any patient being considered for bisphosphonate treatment should be informed of the symptoms of ONJ and, if they occur, to bring these to the attention of their dental practitioner. Therapy should only be initiated if individual risk versus benefit assessment is thought to be favourable. Dental assessment and treatment should be completed before commencing bisphosphonate treatment. Patients receiving bisphosphonates should be strongly advised to tell their dentist that they are taking these medicines before any dental procedure is carried out."

Up to June 2006, 106 cases of osteonecrosis of the jaw (ONJ) have been reported as occurring in the context of treatment with bisphosphonates.

The September issue of Australian Doctor contains an article drawing the attention of medical practitioners to this alert, and so dentists should see some improved recognition of this problem amongst their medical colleagues. This article notes that concern about this issue "has prompted the Australian Dental Association and other main organisations to develop a joint position statement to be released soon. (ADA) spokesman Professor Alastair Goss said it was essential that patients were dentally healthy, did not have an infectious disease and did not require an extraction before they started bisphosphonates."