Bisphosphonate administration — GPhC CRA MCQ
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Correct answer: E — Arrange dental assessment and preventive care before starting treatment
Osteonecrosis-of-the-jaw risk is greatest with potent intravenous bisphosphonates used for cancer, and dental disease or invasive procedures add risk. MHRA advises dental assessment before cancer bisphosphonate treatment and treatment of active oral problems where possible, coordinated with oncology. The risk is not eliminated by switching route, mouthwash or permanent avoidance of all routine dentistry.
Reference: MHRA: bisphosphonates and osteonecrosis of the jaw. https://www.gov.uk/drug-safety-update/bisphosphonates-osteonecrosis-of-the-jaw