Bisphosphonate therapy in a patient scheduled for dental extraction raises the risk of what condition?

• A. Osteoporosis
• B. Hypercalcemia
• C. Osteonecrosis of the jaw
• D. Delayed wound healing

Answer: (C)

When a patient is on bisphosphonate therapy and needs a dental extraction, the main risk to watch for is osteonecrosis of the jaw. Bisphosphonates bind to bone and strongly inhibit osteoclasts, which slows or halts bone remodeling. The jaw, with its high turnover from chewing and frequent dental stress, relies on this remodeling to heal after a tooth is removed. If healing is impaired, exposed bone can become necrotic and infected, leading to osteonecrosis of the jaw. The risk is notably higher with high-dose or intravenous bisphosphonates used for cancer, and it increases with longer duration of therapy and other factors like steroids, infection, or poor oral hygiene. So, the concern isn’t osteoporosis, hypercalcemia, or just delayed wound healing in general—the specific, clinically significant risk in this dental context is osteonecrosis of the jaw.