Paediatric Dentists Treating Children on Bisphosphonates: A Cross-Sectional Questionnaire-Based Study

Area of Science:

• Pediatric Dentistry
• Pharmacology
• Oral Medicine

Background:

• Bisphosphonates are increasingly used in pediatric patients for various conditions.
• Management of dental care for children on bisphosphonates requires specific protocols to mitigate risks like bisphosphonate-related osteonecrosis of the jaw (BRONJ).
• Understanding current practices among pediatric dentists is crucial for developing consistent guidelines.

Purpose of the Study:

• To assess the knowledge and management strategies of pediatric dentists in Australia and New Zealand regarding children undergoing bisphosphonate therapy.
• To evaluate the consistency of management approaches for these patients, particularly concerning BRONJ prevention and treatment.

Main Methods:

• A 19-item online questionnaire was distributed to pediatric dentists in Australia and New Zealand.
• The survey covered demographics, knowledge of BRONJ, professional role and confidence, and management strategies for pediatric patients on bisphosphonates.
• A response rate of 43% was achieved, with 53 valid responses analyzed.

Main Results:

• 40% of surveyed pediatric dentists were involved in managing children on bisphosphonates, while 47% had no role.
• 37% recognized the importance of completing invasive dental treatment before initiating bisphosphonate therapy, with 13% unsure.
• While 83% had received information on BRONJ, significant variability existed in approaches to antibiotic prophylaxis, chlorhexidine use, and drug holidays.

Conclusions:

• A consensus exists regarding the importance of communication between dentists and physicians for children on bisphosphonates.
• However, considerable controversy and lack of uniformity were observed in other critical management strategies related to bisphosphonate therapy.
• Further research and guideline development are needed to standardize care and improve outcomes for pediatric patients on bisphosphonates.