Sir, I read with great interest the letter by D. Regan (BDJ 2005; 199: 754) from both a professional and personal viewpoint. My father was diagnosed with myeloma in 2002 and the author of the letter was a lecturer during my undergraduate years at Sheffield. As a result of my father's diagnosis I have become acutely aware of the problem of jaw osteonecrosis following prolonged use of bisphosphonates. As stated by D. Regan this complication has been widely reported in recent years. I have tried to research the most appropriate way of preventing this complication but cannot find any appropriate advice short of stopping the bisphosphonates three months before treatment, which of course in an emergency situation would not be possible. It has been suggested to me that a high dose of antibiotics pre- and post-treatment may help to prevent the occurrence of osteonecrosis. Are there any evidence-based protocols that BDJ readers are aware of, as this is a complication that is best avoided at all costs?