Kenneth E. Fleisher, DDS, Assistant Professor, Oral and Maxillofacial Surgery, New York University, College of Dentistry, discusses ways that nurses can identify osteonecrosis of the jaw (ONJ), a condition associated with the use of bisphosphonates.

Nurses should question patients on their dental history, specifically whether or not they have required the removal of an infected tooth or experienced pain, swelling, or neurological changes that might suggest an infection or osteonecrosis. When evaluating the oral cavity it is important to look for exposed bone, swelling, fistulas or red areas.

If symptoms occur that may suggest the occurrence of ONJ the patient should be referred to an oral or maxillofacial surgeon for evaluation.