Key Points
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Preventive dental screening reduces the incidence of MRONJ/BRONJ.
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A cross-service cross-healthcare boundary preventive pathway was developed.
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Alternative ways of delivering specialist led MRONJ/BRONJ preventive services can be successful with a robust clinical governance framework.
Abstract
Introduction Bisphosphonates and denosumab reduce the risk of skeletal events in some malignancies (for example, breast, myeloma). These drugs carry a significant risk of a difficult-to-manage side effect of medication related osteonecrosis of the jaw (MRONJ). Preventive dental screening and treatment reduces the incidence of MRONJ. A managed clinical network (MCN) has been used to provide a MRONJ risk reduction pathway. A 360 degree survey was undertaken to assess the effectiveness of the pathway.
Aim The aim of the 360 degree survey was to evaluate if this preventive pathway fulfilled its aims based on patient and stakeholder responses.
Method A multidisciplinary, cross-service, cross-health board MRONJ preventive pathway has been developed. A 360 degree feedback survey of patients and other stakeholders was undertaken.
Results Overall, this survey revealed high levels of satisfaction across patients, oncologists, community dental services, general dental services, and hospital managers.
Conclusion Alternative ways of delivering MRONJ preventive pathways can be developed and assessed using iterative stakeholder feedback aided by a robust clinical governance framework.
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Acknowledgements
The authors wish to thank the oncologists, haematologists, members of the Clinical Governance group, SCD MCN, Maxillofacial unit, and dentists in the CDS and GDS in all three health boards for their feedback and commitment to the pathway.
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Muthukrishnan, A., Al-Ismail, S., Bertelli, G. et al. MRONJ risk reduction pathway - 360 degree survey. Br Dent J 222, 386–390 (2017). https://doi.org/10.1038/sj.bdj.2017.225
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DOI: https://doi.org/10.1038/sj.bdj.2017.225
