gms | German Medical Science

Background: Guidance recommending preventive dental regimes to minimise the risk of bone trauma for patients prescribed bisphosphonates was recently published in Scotland. The aim is to reduce the likelihood of patients developing bisphosphonate-related osteonecrosis of the jaw (BONJ).

Objectives: To provide a baseline measure of general dental and medical practitioners’ (GD/MPs’) current practice and attitudes towards oral health management of patients prescribed bisphosphonates.

Methods: A theory-based questionnaire focusing on the guidance recommendations was mailed to random samples of 300 GD/MPs prior to guidance publication.

Results: 105 GDPs responded. 70% think asking patients about bisphosphonate use is important, but only 60% do. 36% were not confident they could diagnose BONJ, assess BONJ risk (40%) or perform bone-impacting treatment without increasing BONJ risk (64%). Reported behaviour was inconsistent with guidance recommendations. GDPs cited confusion over evidence, low confidence, and lack of practical guidance. 66 GMPs responded. In the past 12 months, 97% prescribed bisphosphonates and 85% were aware of oral complications. Over two-thirds never/rarely advised about BONJ risk, encouraged patients to visit their dentist or instructed patients to notify their dentists of bisphosphonate prescriptions. Despite this, two-thirds have positive attitudes toward these behaviours and do not think they are difficult.

Discussion: This baseline survey and an ongoing follow-up enables assessment of the impact of guidance publication and will inform the development of additional implementation strategies, if required.

Implications for guideline developers/users: Identification of all target users and evaluation of barriers from different professional groups is necessary to support guidance implementation.