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Preventing medication-related osteonecrosis of the jaw

### What you need to know

Osteonecrosis of the jaw is a severe adverse effect reported with certain drugs commonly used in the treatment of cancers and osteoporosis. Although rare, it can severely impair quality of life.1 The number and type of drugs associated with osteonecrosis of the jaw continue to increase, as do their indications. With greater life expectancy and more people living with cancer as a chronic disease, the pool of those “at risk” is increasing.

Management can be costly, invasive, and difficult.2 Clinicians can play a pivotal role in prevention of medication-related osteonecrosis of the jaw by informing patients of the risks when they prescribe these drugs and discussing ways to minimise the risk. In this article we describe the risks associated with different therapies and provide guidance on prevention for non-specialists.

### Data sources and selection

We have drawn on the recommendations from the American Association of Oral and Maxillofacial Surgeons and the Scottish Dental Clinical Effectiveness Programme, with relevant citations identified from their content. We supplemented this with literature from our personal archive of references which includes randomised controlled trials, prospective and retrospective studies as well as case reports. In discussing the risk of medication-related osteonecrosis of the …