| Abstract [eng] |
Summary Relevance. Ideally, bisphosphonate treatment should be started only when the patients undergone dental clearance (all carious lesions are treated, there is no chronic infection, and the periodontal condition is stabilised). Due to lack of cooperation between specialists, the correct treatment algorithm is chosen less frequently than it should be, which increases the risk of bisphosphonate related osteonecrosis of the jaw (BRONJ). Therefore, it is important to investigate the knowledge of rheumatologists, endocrinologists and family doctors in Lithuania on the impact of bisphosphonates on oral health and to educate the medical community so that referral to a dentist for a consultation prior to bisphosphonate treatment becomes routine practice. Objective. To assess the knowledge of dentists, endocrinologists, rheumatologists and family doctors on the impact of bisphosphonates on oral health. Tasks. 1. To assess the knowledge of different specialty physicians on the impact of bisphosphonates on oral health. 2. To compare the knowledge of different specialty physicians on the impact of bisphosphonates on oral health. 3. Provide recommendations to dentists, endocrinologists, rheumatologists and family doctors on the management of patients who have been treated, are currently being treated, or are planned to be treated with bisphosphonates. Materials and methods. A single-centre study was conducted. The study included 20 endocrinologists, 27 rheumatologists, 135 family doctors and 209 dentists. The survey instrument was an anonymous test type questionnaire. The questionnaire consisted of two parts: the first part on the physicians' experience with bisphosphonate-related osteonecrosis of the jaw, and the second part on the physicians' knowledge of dental procedures in patients receiving bisphosphonates. Statistical analysis of the study data was performed using the RStudio statistical analysis software environment. Welch's t-test was used to analyse the results. 5 Results. The results showed that the average knowledge of dentists is higher than that of doctors who prescribe bisphosphonate treatment to patients. The mean knowledge score for dentists is 4.73 and for bisphosphonate prescribing physicians is 3.81. The Welch's T-test showed a strong statistical significance (p-value less than 0.001), and the 95 percent confidence intervals [-1.14, -0.69] also indicate a statistically significant difference in means. Conclusions. Dentists have good, rheumatologists moderate, family doctors and endocrinologists satisfactory knowledge of the impact of bisphosphonates on oral health. The general knowledge of physicians prescribing bisphosphonates on the impact of the bisphosphonates on specific dental procedures is moderate. Dentists have statistically significantly more knowledge of the effects of bisphosphonate use on patient oral health than specialists prescribing bisphosphonate treatment. In Lithuania, there is a lack of interdisciplinary communication between physicians prescribing bisphosphonates and dentists, which is one of the factors predisposing to bisphosphonate related osteonecrosis of the jaw. A relatively high proportion of family doctors do not provide patients with information on the risk of developing BRONJ. |
