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• W2109803886 abstract "The exposure of dead necrotic bone in the oral cavity is commonly referred as OsteoNecrosis of the Jaw (ONJ). Some known causes of ONJ include exposure to radiation, ingestion of radioactive elements such as radium, exposure to phosphorus or intake of intravenous or oral bisphosphonate medications. It is unclear what factors may prevent ONJ if either medical or environmental exposure is unavoidable.Oral hygiene was suggested as effective ONJ prevention in the 19th century when the industrial fabrication of matches became associated with a first wave of ONJ cases.1 The hypothesis that “clean teeth do not decay” was popular in those days. The specific recommendations were to clean the teeth with a small toothbrush with stiff bristles at least once a day with powder (soap with precipitated chalk). Rinsing after each meal and avoiding potential traumatic injury to the teeth (for instance, by eating nuts) was also recommended.2The recommendation to practice good oral hygiene has survived the centuries. An expert panel convened by Novartis Pharmaceuticals Corporation reported that for the prevention of ONJ, “patients should be educated on maintaining excellent oral hygiene to reduce the risk of infection.”3 Similarly, the American Dental Association reported that good oral hygiene is the best way to lower the risk for ONJ.4 To our knowledge, no controlled evidence is available to determine whether oral hygiene is an effective preventive method.We briefly report here on some preliminary findings of a nationwide case-control study on the etiology of ONJ as it relates to the role of oral hygiene. Three Practice Based Research Networks (PBRNs) funded by the National Institute of Dental and Craniofacial Research designed a common protocol for a case-control study of ONJ.5 This case-control study collected data on oral hygiene to determine its relationship to subsequent ONJ risk. Information on brushing, flossing and rinsing approximately 5 years before the onset of ONJ was collected. The question on the use of oral rinses was not specific with respect to the ingredients or active agents. A total of 191 cases and 573 controls formed the basis for the primary analyses. In univariate analyses, there was no significant association between brushing, flossing, or the use of oral rinses with ONJ. Patients reporting to brush once or more than 1 time per day versus those reporting not to brush once a day did not have a lowered ONJ risk (OR = 0.84, p-value = 0.69). Patients reporting to floss once or more per day had no reduced odds for ONJ when compared to those not reporting to floss once a day (R=0.9, p-value=0.56). Finally, no association was present between the use of oral rinses and ONJ. When comparing those individuals that rinsed 4 or more times a week versus those reporting to rinse 3 or fewer days a week, the odds ratio was 0.95 (p-value=0.82). After adjustment for confounding variables, no association could be identified between oral hygiene procedures and the prevention of ONJ.In conclusion, these exploratory findings in this case-control study could not find evidence that oral hygiene plays a role in the prevention of the onset of ONJ. The potential bias associated with recollecting oral hygiene habits is an important weakness of these presented data. Future studies could collect information on oral hygiene habits to either confirm or refute these first evidence-based data on oral hygiene and ONJ prevention." @default.
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• W2109803886 date "2012-01-01" @default.
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• W2109803886 title "Osteonecrosis of the jaw and oral hygiene: a case-control study from Condor Dental PBRN." @default.
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