Background: An invasive dental procedure is considered as one of the risk factors for osteonecrosis of the jaw, especially among patients on bisphosphonates. This study aimed to determine the awareness and perceptions of medical practitioners regarding bisphosphonate-related osteonecrosis of the jaw (BRONJ), and their attitude towards dental referrals of such patients. Methodology: Methodology: This cross-sectional questionnaire-based study was conducted with medical practitioners in and around Mysore city, Karnataka, India, who commonly prescribe bisphosphonates. The sample included orthopaedic doctors, physicians, endocrinologists, and oncologists- divided based on the duration of practice and speciality. Data on the type of practice, awareness of BRONJ, referral to a dentist before/during therapy, and patient education about adverse effects were collected and analyzed. A p value ≤0.05 was considered statistically significant. Results: Among 58 practitioners, 84.5% (49) were aware of the association between bisphosphonates and BRONJ. While 56.9% (33/58) believed dental procedure to be a risk factor, 55.2% (32/58) did not recommend screening of the oral cavity by a dentist before initiation of bisphosphonate therapy. A majority (65.5%) of them educated their patients about adverse effects. Mean knowledge scores varied with specialization (post-graduation vs super specialization= 1.43 vs 2; p = 0.01) but not with the duration of practice (<= 10 years vs >10 years= 1.57 vs 1.4; p= 0.24). Conclusion: The practitioners in our study were oblivious to dental procedures' role in the osteonecrosis of the jaw, highlighting the need of continuing education programs regarding BRONJ for medical and dental professionals. Clinicians who are updated about evidence-based practices and working cooperatively in teams may reduce the incidence of medication-related osteonecrosis of the jaw.

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