There is a paucity of information to guide our advice with respect to rheumatology clinic patients.

Link to Canadian Guidelines

In the Rheumatology Division, based on the limited information available, we give this advice:

When starting a bisphosphonate for OP:

• Tell patient about the rare association of ONJ
• Ask if any acute dental problems If yes, hold starting drug and refer to dentist.
• Ask if any pending dental work. If yes, hold starting drug and start drug after the dental work is done.
• Ask if “routine dental care” has been done. If not, can one still start drug and refer to dentist?