2016 Volume 18 Issue 3 Pages 201-207
Bisphosphonates and antiresorptive medications have been widely used for the treatment of multiple myeloma bone diseases, and bone metastasis of solid cancers. Many cases of bisphosphonate and antiresorptive medication related osteonecrosis of the jaw (ONJ) have been reported in Japan. The departments of Medicine and Dentistry had been directed to collaborate on the prevention and treatment of ONJ. We decided to manage the prevention and treatment of ONJ in collaboration with medical doctors, dentists and local dental clinics. In order to promote cooperation between the departments and local dental clinics, we developed a liaison-clinical pathway to enable regional cooperation and simplify responsibilities and information sharing among the collaborating entities. Before implementing the liaison-clinical pathway, a dentist is required to orally screen a patient based on a medical doctor’s request. The actual oral management and ONJ prevention measures are then performed by a local dental clinic. We had applied the liaison-clinical pathway to 11 patients by November 2015, two of whom developed ONJ.
The liaison-clinical pathway enables the sharing of patient information, facilitating collaboration between hospitals and local dental clinics for the prevention and treatment of ONJ. However, information sharing and ONJ prevention methods must be improved.
