title: Knowledge, practices, and opinions of ontario dentists when treating patients receiving bisphosphonates.
abstract: OBJECTIVE
  Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a severe but extremely rare complication of prolonged treatment with bisphosphonates (BPs). Improper treatment or misdiagnosis can have serious repercussions. In some cases, the treatment of BRONJ can require jaw resection, prolonged use of antibiotics, and long hospitalizations. This study aimed to measure the awareness of dentists in the Province of Ontario, Canada about BRONJ and to identify any gaps in their knowledge of the condition and its treatment. In particular, the study aimed to answer questions about the dentists' knowledge of the current guidelines and their opinions and practices related to performing surgical dental procedures in patients taking BPs.
  
  
  METHODS
  The study involved sending a Web-based questionnaire to a random sample of dentists in Ontario, Canada (n = 1,579). Information about their awareness of BPs, their experiences treating patients presenting with ONJ, their experiences with different surgical procedures in patients taking intravenous or oral BPs, and their awareness of the BRONJ guidelines suggested by the American Association of Oral and Maxillofacial Surgeons was collected.
  
  
  RESULTS
  A response rate of 30% was achieved. Sixty percent of responding dentists had a good knowledge of BP and BRONJ; however, only 23% followed the guidelines for surgical treatment of a patient taking BPs, and 63% would refer patients if they were taking BPs. Approximately 50% of responding Ontario dentists were not comfortable treating patients with BRONJ at their current knowledge.
  
  
  CONCLUSIONS
  The finding shows that although 60% of Ontario general dentists and specialists have a good knowledge about BRONJ, most are not comfortable performing oral surgery in patients taking BPs. Those who are comfortable have higher knowledge scores, suggesting greater educational efforts should be made to promote the knowledge of dentists regarding BP, ONJ, and BRONJ.
authors.affiliation: Former Resident, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Alhussain
authors.affiliation: Assistant Professor, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.
authors.forename: Sean
authors.initials: S
authors.lastname: Peel
authors.affiliation: Assistant Professor, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Dempster
authors.affiliation: Professor, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.
authors.forename: Cameron
authors.initials: C
authors.lastname: Clokie
authors.affiliation: Assistant Professor, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada. Electronic address: amir.azarpazhooh@dentistry.utoronto.ca.
authors.forename: Amir
authors.initials: A
authors.lastname: Azarpazhooh
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000517:prevention & control* / Q000628:therapy; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000517:prevention & control / Q000556:secondary; D003430:Cross-Sectional Studies; D017742:Dental Care for Chronically Ill; D003815:Dentists / Q000523:psychology*; D004164:Diphosphonates / Q000627:therapeutic use*; D004497:Education, Dental; D004498:Education, Dental, Continuing; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D019647:Oral Surgical Procedures / Q000379:methods; D010024:Osteoporosis / Q000188:drug therapy; D017410:Practice Guidelines as Topic; D019239:Practice Patterns, Dentists'; D012017:Referral and Consultation
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates