Dental Management of Patients on AntiresorptiveMedications Should you extract a tooth if your patient is taking a bisphosphonate? Patients on bisphosphonates or other antiresorptive medications are at risk of developing medicationrelated osteonecrosis of the jaw (MRONJ). This is a rare, but serious, complication that may damage the jaw after a tooth extraction in patients taking antiresorptives. Let’s consider the precautions that dentists should take when managing patients on antiresorptive medication. Dr. Sanjukta Mohanta is a general dentist practising in Toronto. Follow her on Instagram at @drsanjmohanta Antiresorptives Antiresorptive medications are prescribed for patients with osteoporosis, bone malignancies, hypercalcemia of malignancy, or Paget’s Disease. The medications work by reducing the activity of osteoclasts, cells that dissolve and break down old or damaged bone. They also stimulate osteoblasts, cells that make new bone. Antiresorptive medications prevent bone loss, may increase bone density and lower the risk of broken bones. Antiresorptive medication can be given orally or via injection. The method of administration is important because antiresorptives via injection have a higher risk of MRONJ compared to those taken orally.1 The risk of MRONJ when taking oral bisphosphonates is extremely low (about 1 in 100,000) compared to those who do 38 | 2024 | Issue 5
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