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Dental clearance for bisphosphonates form

Bisphosphonate dental clearance 2025

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The document outlines the need for dental clearance before initiating bisphosphonate treatment for conditions such as multiple myeloma, metastatic cancer, and osteoporosis. It emphasizes the potential risk of osteonecrosis in patients undergoing dental procedures while on these medications. A complete dental evaluation is required to ensure the patient is free of active dental issues before starting treatment.

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Are bisphosphonates renally cleared?

Approximately 50-80% of available bisphosphonate is taken up by bone. The remaining 30-50% is excreted in without being metabolised. The uptake of bisphosphonate by bone increases with high bone turnover or low renal excretion.

How long to be off bisphosphonate before tooth extraction?

A minimum of 4 weeks should have passed before starting treatment following dental procedures where bone has been exposed or manipulated. While on treatment avoid dental procedures if possible. Patients should be encouraged to have regular dental check-ups whilst on treatment, at least every 6 months.

Why do you need dental clearance for bisphosphonates?

A dental clearance is often recommended before starting bisphosphonate therapy to identify and address any existing dental issues that could increase the risk of ONJ. Dental problems such as untreated infections, poor oral hygiene, or the need for invasive dental procedures can contribute to the development of ONJ.

How long does bisphosphonate stay in your system?

Unlike most medications, bisphosphonates remain in the body for decades. These drugs are not metabolized, but are either excreted renally or deposited within the bones. The amount of drug within the bone will accumulate with use. There is no known method of removing the medication from the bones.

What is the GFR cut off for bisphosphonates?

Although bisphosphonates are first-line anti-osteoporosis therapies for preventing fractures, their use is contraindicated or to be used with caution in patients with an estimated glomerular filtration rate (eGFR) under 30 mL/min/1.73 m2.

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What is the clearance of bisphosphonates?

Bisphosphonates are eliminated from the human body by the kidney. Renal clearance is both by glomerular filtration and proximal tubular secretion.