Dental extractions in primary care for patients at risk of MRONJ

Sheryl Wilmott; Julian Yates; Iain A Pretty

doi:10.1038/s41415-021-3674-8

Dental extractions in primary care for patients at risk of MRONJ

Br Dent J. 2021 Dec 9. doi: 10.1038/s41415-021-3674-8. Online ahead of print.

Authors

Sheryl Wilmott¹, Julian Yates², Iain A Pretty³

Affiliations

¹ Speciality Dentist in Oral and Maxillofacial Surgery, Leeds Teaching Hospitals Trust, Leeds, UK. sheryl.wilmott@nhs.net.
² Professor of Oral and Maxillofacial Surgery/Honorary Consultant in Oral Surgery, University of Manchester Dental School, Manchester, UK.
³ Specialist in Dental Public Health, University of Manchester, Manchester, UK.

PMID: 34887554
DOI: 10.1038/s41415-021-3674-8

Abstract

Aims This study aims to understand the experiences of general dental practitioners (GDPs) performing dental extractions for patients at risk of developing medication-related osteonecrosis of the jaw (MRONJ) and to identify the key features of the patients who are referred to secondary care for their extractions.Materials and methods A mixed-method study consisting of quantitative analysis of anonymised electronic referrals and thematic analysis of in-depth telephone interviews with GDPs.Results In total, 122 electronic referrals for patients at risk of MRONJ were identified. The majority of the referrals contained insufficient information to categorise the patient's risk of developing MRONJ. In-depth telephone interviews with six GDPs were analysed and the themes identified were consequences, difficult decisions, patient awareness and bridging the gap.Conclusion Our results show that fewer than half of the referrals to secondary care investigated in this study showed a clear indication for secondary care involvement and the quality of the patient information provided was often insufficient to determine the patients' risk of developing MRONJ. Improved local guidance for the management of these patients and a dedicated pathway for their post-operative complications may encourage GDPs to perform more of these dental extractions in practice.