Which BP are they taking? Why are they taking a BP? Duration of BP therapy? Recent dental extraction? Symptomatic? That is, pain? Other risk factors? Previous radiotherapy? Dental or OMFS input?
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Any mucosal ulceration? Any exposed bone? Signs of local infection? Signs of soft-tissue swelling? Signs of recent dental extraction? Examine skin for fistula Could it be oral cancer?
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Discuss the need for dental assessment before starting BP therapy Prescribe antimicrobial mouth rinse (chlorhexidine) Give antibiotics if signs of local inflammation/infection Refer appropriately to OMFS team
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