Medication Related Osteonecrosis of the Jaw: Knowledge, Attitudes and Practice Patterns Among Australian Dental Practitioners

BACKGROUND: Medication related osteonecrosis of the jaw (MRONJ) is a debilitating condition associated with antiresorptive and antiangiogenic therapies. As the use of these medications continues to increase, dental practitioners play a critical role in prevention and management of at-risk patients. This survey evaluated the awareness, knowledge and practice patterns of Australian dental practitioners regarding MRONJ. MATERIALS AND METHODS: A cross-sectional online survey of registered Australian dental practitioners was conducted. The 26-item questionnaire assessed knowledge of MRONJ diagnosis, clinical features, risk factors and practice patterns. Responses were analysed descriptively. RESULTS: A total of 343 dental practitioners participated. Overall MRONJ awareness was high, with 88.6% correctly identifying the principal diagnostic criteria. Knowledge of antiresorptive medications was strong, but familiarity with antiangiogenic agents was limited, with 25% unable to identify any associated medication. Only 62.4% were comfortable assessing MRONJ risk before extraction and just 37.9% comfort in performing extractions in at-risk patients. Public practitioners reported greater MRONJ-related education and clinical confidence than private practitioners. CONCLUSION: Australian dental practitioners demonstrated strong awareness of MRONJ. However, confidence in providing invasive treatment for at-risk patients remained limited, particularly among private dental practitioners. These findings highlight the need for targeted education and clinical support as the use of MRONJ associated medications continues to increase. CLINICAL RELEVANCE: Although overall awareness of MRONJ is high among Australian dental practitioners, ongoing knowledge and confidence gaps may contribute to variation in clinical practice. Addressing these gaps through continuing professional education, evidence-based guidance, and structured risk assessment may enhance patient safety and optimise the prevention and management of MRONJ.