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Learning scenario

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How do you respond?

Suggest James brings his dental appointment forward

CORRECT. Dental pain can be a sign of osteonecrosis of the jaw, which is associated with bisphosphonate use.

Ask if he smokes

CORRECT. Tobacco use is not advised when on bisphos-phonates due to the increased risk this poses to the jaw.

Provide him with a pack of co-codamol and tell him to come back for more when they are finished

INCORRECT. This is not a helpful suggestion given what the problem could be, nor is it sensible to advise opioid use.

Sell him some antiseptic mouthwash

INCORRECT. This is poor advice given that James could be suffering from osteonecrosis of the jaw.

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