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Microsoft word - informed consent concerning bisphosphonate drugs and dental treatment.doc
Informed Consent Concerning Bisphosphonate Drugs and
If you have been treated, if you are currently being treated, or if you plan to be treated in the future with Bisphosphonate drugs, such as Residronate (Actonel)*, Etidronate (Didronel), Tiludronate (Skelid), Alendronate (Fosamax)*, Pamidronate (Aredia)*, and Zoledronate (Zometa)* (*nitrogen containing) that are used on patients being treated for osteoporosis, in particular postmenopausal women, and also those whom have a history of chemotherapy treatment or Paget’s disease of the bone, you should know that there is a significant risk of future complications associated with dental treatment. Bone is a living tissue with living cells and a blood supply. Osteonecrosis means death of bone which can occur when there is a loss of blood supply or a problem with the bone’s ability to re-grow. Although the risk of developing osteonecrosis of the jaw is low with any procedure, it is higher with procedures involving bone and associated tissues, such as tooth extractions, periodontal surgery, and dental implants (estimated at less than one person per 100,000 minus the years of exposure to the drug). Still you should be aware of this risk of complication because it is a serious, long-term, destructive condition with no known treatment. At this time, there is no way to determine who will develop the disease, but
current medications being taken and health problems may play a role in the development of osteonecrosis. Therefore your medical/dental history and is very important. We must know the medications and drugs taken or currently taking, or planning on taking. Names and phone numbers of physicians are important in order for pre-dental treatment consultation. Bisphosphonate drugs appear to adversely affect the ability of bone to break down or remodel itself thereby reducing or eliminating its ordinary excellent healing capacity. This risk is increased after surgery, especially from extraction; implant placement; or other “invasive” procedures that might cause even mild trauma to bone. Oral hygiene is the best way to prevent oral diseases that may require dental surgery. The signs and symptoms to be aware of feeling now and in the months following treatment are: ·
Feeling of numbness, heaviness or other sensations in your
Tell us immediately if you have any of these symptoms. Although your risk for developing osteonecrosis of the jaw is very small, you may be at an increased risk for developing other health problems if a dental disease or condition is not treated. The benefits of reducing hip fractures and other complications associated with osteoporosis can be very important. You should talk to your physician if you have any questions, Dr. Hanna cannot
advise you to stop taking the oral bisphosphonate. Also, it has not been shown that stopping the use of bisphosphonate will decrease your risk for developing osteonecrosis. I have fully read and understand this document. I have had all my questions and concerns fully answered to my satisfaction. I have been offered no guarantees as to the result of the proposed treatment.
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The Ethics of Social Work. Principles and Standards Adopted by the IFSW General Meeting, Colombo, Sri Lanka, July 6 -8, 1994 1. Background Ethical awareness is a necessary part of the professional practice of any social worker. His or her ability to act ethically is an essential aspect of the quality of the service offered to clients. The purpose of IFSW's work on ethics is to
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