Denosumab and Planned Dental Surgery: Coordinating Timing

Coordinate two genuine health priorities

If you take denosumab and need dental surgery, the plan needs to protect your bones as well as manage your teeth. Timing depends on why it is prescribed, the injection schedule and your dental findings. Do not skip or delay an injection on the strength of online advice; the dental and prescribing teams need to coordinate your care. [1]

Do not assume stopping treatment removes the risk

NOGG notes that there are no data establishing that stopping treatment around required dental procedures reduces osteonecrosis risk. It also describes increased fracture risk after stopping osteoporosis treatment. The treating medical professional's assessment of benefits and risks should guide the plan. [1]

Necessary dental care should remain accessible

Dental disease, poor oral hygiene and invasive procedures are relevant to the jaw-risk assessment. Routine preventive care should continue, and indicated invasive treatment can often be carried out successfully with appropriate planning. Higher-dose treatment for cancer must be distinguished from osteoporosis treatment. [1]

Bring the details that allow coordination

Provide the dentist with the drug name, indication, prescribing team's details and injection dates that you know. Ask who will agree any scheduling decision and how the site will be reviewed after surgery. Report a non-healing wound, exposed bone, discharge, swelling or altered sensation promptly. [2]

Research and guidance

1. Primary professional guidance — www.nogg.org.uk
2. Recommendations | Scottish Dental Clinical Effectiveness Pro