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1、Towne Lake Family Dentistry, Ltd.Where Beautiful Smiles BeginRay H. Morgan, Jr., DMD Dennis L. Radcliffe, DDS, FAGD120 North Medical Parkway, Building 200, Suite 100Woodstock, GA 30189 770-591-TREATMENT CONSENT FOR PATIENTS TAKING BISPHOSPHONATESDr. Morgan and Dr. Radcliffe (your dentist) want you t
2、o understand the treatment you are considering. To do so, you need to understand the risks associated with that treatment, as well as benefits of the treatment. Your dentist also wants you to understand the alternatives available to you, from doing no treatment to other treatment options. This is al
3、so an ideal time for you to ask questions you may have. By signing this consent to treatment form, you are indicating that you and your doctor(s) have thoroughly discussed the risks, benefits and alternatives for the treatment you will be given and that you have understood that discussion.The follow
4、ing provides you with some additional information about dental treatment for patients taking oral bisphosphonates.Because you are taking a type of drug called a bisphosphonate, you may be at risk for developing osteonecrosis of the jaw and certain dental treatments may increase that risk. You should
5、 understand that the risk for developing this condition is very small.What is osteocronosis of the jaw? Bone is a living tissue with living cells and a blood supply. Osteocronosis means death of bone, which can occur from the loss of the blood supply or by a problem with the bones ability to regrow.
6、 Very rarely, osteocronosis of the jawbone has occurred in individuals taking oral bisphosphonates for treatment of osteoporosis or Pagets disease of bone. Dental treatments that involve the bone can make the condition worse.What is the risk for developing osteocronosis of the jaw? Your risk for dev
7、eloping osteocronosis of the jaw, from using oral bisphosphonates, is very small (estimated at less than one person per 100,000 personsyears of exposure to the drugs Fosamax, Actonel or Boniva); but, if it does occur, it may be a serious condition with no known treatment so you should be aware of th
8、is complication. At this time, there is no way to determine who will develop the disease. However, the condition is rare and has just recently been associated with the use of oral bisphosphonates. It is important for you to understand that other factors may play a role in the development of osteocro
9、nosis, such as other medications you are taking and health problems that you may have.Should I stop taking oral bisphosphonates? The benefits of reducing hip fractures and other complications associated with osteoporosis can be very important. Dr. Morgan and Dr. Radcliffe cannot advise you about the
10、se benefits. You should talk with your physician if you have any questions. Also, it has not been shown that stopping use of the drug will decrease your risk for developing osteocronosis.What are the risks associated with dental procedures? Although the risk is low with any procedure, it is higher w
11、ith procedures involving the bone and associated tissues, such as tooth extractions, implants or periodontal surgery.How can I decrease my risk of developing osteocronosis of the jaw? Talk to your dentist about oral hygiene, because maintaining good oral hygiene is the best way to prevent oral disea
12、ses that may require dental surgery.What are the signs and symptoms of osteocronosis of the jaw? You should tell your dentist immediately if you have any of the following symptoms, now or in the months following treatment: feeling of numbness, heaviness or other sensations in you jaw, pain in your j
13、aw, swelling of your jaw, loose teeth, drainage, or exposed bone.What other choices do I have if I do not have the procedure? Your treatment options depend on the oral health condition that you have.Risks associated with not having the procedure: Your risk for developing osteocronosis of the jaw is
14、very small. You may be at increased risk for developing other health problems if dental disease is not treated. Your dentist will be able to discuss alternative treatments, other risks associated with various treatment options, and the risk of no treatment, even temporarily. You should also consult with your treating physician about any health risks.Patient Name: _Date: _Signature: _Witness: _Dentist Signature: _
