| Management |
Caution is advised if bisphosphonates are used simultaneously or sequentially with denosumab or bevacizumab. Prior to initiating treatment, a thorough dental examination and appropriate preventive dentistry should be considered. If possible, invasive dental procedures should be avoided in patients who have previously received or are receiving intravenous bisphosphonates. Good oral hygiene practices should be maintained during treatment. Patients should be advised to seek medical attention if they experience signs and symptoms of osteonecrosis in the jaw, such as: pain in the mouth, teeth, or jaw, swelling or sores inside the mouth, numbness or a feeling of heaviness in the jaw, loosening of a tooth, or exposure of bone in the jaw. Temporary interruption of treatment should be considered if clinically appropriate, until the condition resolves. |