Should We Be Concerned About Jaw Osteonecrosis with Oral Bisphosphonates?

Increasingly, patients are asking physicians about bisphosphonate-related osteonecrosis of the jaw (BRONJ). Some patients are researching the topic themselves on the Internet before starting bisphosphonate drugs that are recommended by their physicians. In other cases, dentists are reluctant to perform invasive dental procedures in patients who are taking these drugs. How should primary care physicians respond to these patients or their dentists?

First, some background: BRONJ is defined as exposed, necrotic bone in the maxillofacial region that persists for more than 8 weeks in current or past recipients of bisphosphonate therapy.1^,2 The condition can occur spontaneously or after invasive dental procedures. These lesions often expand — somet…