Viewpoints of dentists on the use of bisphosphonates in rheumatology patients

Abstract

Alhough typically prescribed in oncology, bisphosphonates (BPs) are also employed in rheumatology, particularly for the treatment of osteoporosis, sometimes resulting in complications, such as osteonecrosis of the jaw. Because of different opinions between rheumatologists and dentists on BP use, this study aimed to assess the views of dentists regarding administration of BPs in rheumatology. A questionnaire was sent to 880 dentists from the Auvergne region of France to determine their views on BP treatment. We obtained 382 (43.4%) responses and analysed 376 (58.7% men). In total, 156 (41.5%) of the responders analysed had attended an in-service training course (ISTC) on the topic. A total of 237 (63.0%) systematically inquired as to whether their patients were undergoing BP treatment; this proportion was higher among those who had been practicing for fewer than 10years (P<0.004). For patients receiving BPs, 84.5% of practitioners felt ill at ease about performing dental surgery (n=318) and 11% felt ill at ease about performing nonsurgical dental care (n=41); 67% stated that their practice differed depending on the method of BP administration (peros or intravenously). Overall, 53.7% of practitioners felt uncomfortable when asked by a rheumatologist whether a given patient's dental status permitted prescription of BP (n=202). This proportion was higher among those who had never attended an ISTC (62.6% vs. 50.7%; P<0.03). Dentists feel ill at ease providing dental surgery to patients receiving BPs. Closer collaboration and better information-sharing between rheumatologists and dentists is necessary to facilitate the administration of BPs in rheumatology.