Table 3.122.

Key considerations for dental management in osteoporosis (see text)

	Management modifications*	Comments/possible complications
Risk assessment	1	Jaw fracture Osteochemonecrosis due to bisphosphonates
Appropriate dental care	1
Pain and anxiety control
– Local anaesthesia	0
– Conscious sedation	0
– General anaesthesia	1	Neck and chest deformities
Patient access and positioning
– Access to dental office	1	Assistance/escort
– Timing of treatment	0
– Patient positioning	1	Neck support; mobility reduced
Treatment modification
– Oral surgery	1	Jaw fracture; delayed alveolar bone healing Osteochemonecrosis due to bisphosphonates
– Implantology	1	Avoid sinus lifts
– Conservative/Endodontics	0
– Fixed prosthetics	0
– Removable prosthetics	1	Unstable prosthesis; soft-relining required
– Non-surgical periodontology	0
– Surgical periodontology	1	Impaired bone remodelling
Imaging	1	Typical radiological features
Hazardous and contraindicated drugs	1	Avoid tetracyclines

^*0 = No special considerations. 1 = Caution advised. 2 = Specialised medical advice recommended in some cases. 3 = Specialised medical advice mandatory. 4 = Only to be performed in hospital environment. 5 = Should be avoided.