Dental management of patients receiving oral bisphosphonate therapy: expert panel recommendations

J Am Dent Assoc. 2006 Aug;137(8):1144-50. doi: 10.14219/jada.archive.2006.0355.


Background: In light of the uncertainty surrounding the incidence of bisphosphonate-associated osteonecrosis of the jaw (BON) and concomitant risk factors, dentists have questioned how to manage the care of patients receiving oral bisphosphonate therapy. Expert panelists were selected by the American Dental Association Council on Scientific Affairs on the basis of their expertise in the relevant subject matter and on their respective dental or medical specialties, and the panel was tasked with developing guidance for dentists treating these patients.

Methods: There are no data from clinical trials evaluating dental management of the care of patients receiving oral bisphosphonate therapy and, therefore, these recommendations are based on a thorough review of the available literature relating to bisphosphonate use and osteonecrosis of the jaw. After reviewing the literature, the panel developed these recommendations based on their expert opinion.

Results: These panel recommendations focus on conservative surgical procedures, proper sterile technique, appropriate use of oral disinfectants and the principles of effective antibiotic therapy.

Conclusions: The recommendations are a resource for dentists to use in their practice, in addition to the dentist's own professional judgment, the information available in the dental and medical literature, and information from the patient's treating physician. The recommendations must be balanced with the practitioner's professional judgment and the individual patient's preferences and needs.

Publication types

  • Practice Guideline

MeSH terms

  • Administration, Oral
  • Anti-Bacterial Agents / therapeutic use
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / therapeutic use*
  • Decision Making
  • Dental Care*
  • Diphosphonates / administration & dosage
  • Diphosphonates / therapeutic use*
  • Disinfectants / therapeutic use
  • Humans
  • Jaw Diseases / chemically induced
  • Jaw Diseases / prevention & control
  • Oral Surgical Procedures / methods
  • Osteonecrosis / chemically induced
  • Osteonecrosis / prevention & control
  • Risk Factors
  • Sterilization


  • Anti-Bacterial Agents
  • Bone Density Conservation Agents
  • Diphosphonates
  • Disinfectants