The American Association of Endodontists (AAE) has issued a position statement on the care of patients taking bisphosphonates, recommending that all patients taking these drugs be considered at some risk of developing osteonecrosis of the jaw (ONJ).

Bisphosphonates are used to treat certain cancers and bone diseases such as Paget's disease and osteoporosis. They support the build-up of bone in areas weakened by disease but have the potential side effect of ONJ, in which the opposite effect occurs in the jawbones.

While recognising that the magnitude of risk varies for each patient, the AAE says it is essential that patients taking bisphosphonates receive advice before undergoing elective dental surgery. Any non-elective dental work, in particular extractions, should be completed before bisphosphonate therapy begins, and patients taking bisphosphonates are encouraged to inform their dental care providers and consult with specialists as needed.

The statement is based on the findings of a special committee assembled by the AAE to review scientific data on the relationship between bisphosphonates and ONJ. Case reports suggest that ONJ in patients taking bisphosphonates may be triggered by tooth extractions and other surgical events, although it can also occur spontaneously.