Journal of Disability and Oral Health

cover art

Cover Date:
March 2014
Print ISSN:
1470-8558
Vol:
15
Issue:
1

A retrospective audit investigating domiciliary dental care in patients taking bisphosphonates

Abstract
Patients receiving domiciliary dental care are typically housebound elderly patients who, compared to the general population, are more likely to be taking bisphosphonates due to morbidity and immobility. Current UK guideline recommendations are useful in identifying and reducing the level of risk of patients developing bisphosphonate osteonecrosis of the jaw when undergoing extractions and provision of dentures. Aims and objectives: The aim of this audit was to elicit the proportion of domiciliary patients taking bisphosphonates in two London boroughs, and whether patients were managed appropriately in accordance with national guidelines. Methodology: 207 domiciliary dental patient records were reviewed retrospectively over a six month period. Details of treatment provided, complications and post-operative monitoring following dental intervention were recorded. Results: Just over a quarter of patients in the sample were taking bisphosphonates orally and 3% intravenously. Only 38% of domiciliary patients on bisphosphonates were reviewed after extractions, and 68% after denture provision compared to 61% and 70% of non-bisphosphonate patients respectively. The overall incidence of BONJ in this population was 1.9%, with suspected BONJ occurring in 12.5% of patients following dental intervention. Conclusion: The proportion of domiciliary patients taking bisphosphonates is high. The risk in this population of developing BONJ is unknown, but may be greater due to co-morbidities and poor oral health. This paper proposes an ideal management pathway for domiciliary patients on bisphosphonates, emphasising the need to review patients more frequently especially after dental intervention. Collaboration with family members, carers and care home managers to promote oral health is paramount in preventing complications in this group.

Key words: Domiciliary dentistry, bisphosphonates, osteonecrosis

Doi: 10.4483/JDOH_Shehabi07

Article Price
£15.00
Institution Article Price
£0.00
Page Start
5
Page End
11
Authors
Z Shehabi, C Colhoun, C Y F Chan

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  1. Editorial: Special Care Dentistry – a specialty or a need for more caring dentists?
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  1. A retrospective audit investigating domiciliary dental care in patients taking bisphosphonates
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  3. 11

  1. Oral health status and treatment needs of residents at the Jerash Centre for Welfare and Rehabilitation
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  1. Tongue retractor developed for occlusal adjustment under general anaesthesia
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