American Board of Internal Medicine (ABIM) Certification Practice Exam

What essential evaluation should patients receiving bisphosphonates or denosumab have before treatment?

1. Baseline cardiac evaluation

2. Baseline dental evaluation

3. Baseline neurological assessment

4. Baseline thyroid function test

The correct answer is: Baseline dental evaluation

Patients receiving bisphosphonates or denosumab should undergo a baseline dental evaluation before treatment due to the risk of osteonecrosis of the jaw (ONJ), a serious condition that can occur as a side effect of these medications. Bisphosphonates and denosumab are primarily used to treat osteoporosis and other bone-related conditions by inhibiting bone resorption, but they can affect the jawbone's healing capacity, especially after dental procedures. A comprehensive dental evaluation allows healthcare providers to identify any pre-existing dental issues, such as periodontal disease or the need for extractions, which could increase the risk of developing ONJ once treatment is initiated. Additionally, dental providers may recommend preventive measures or necessary dental interventions before commencing bisphosphonate or denosumab therapy to mitigate this risk. Ensuring optimal dental health before treatment is a crucial step in the management of patients on these medications.