MetLife MetDental Accreditation Information

Part 1 – Background, Incidence and Risk Factors 6th Edition

Bisphosphonates and other medications are used increasingly more often by physicians in the treatment of benign and malignant bone diseases.  A number of reports describing a unique type of osteonecrosis in the maxillas and mandibles of patients on bisphosphonate therapy have been published over the past few years.  The sixth edition of this Guide discusses the pathogenesis of bisphosphonate and other medication-related osteonecrosis of the jaw (MRONJ) and outlines the risk factors that may affect onset of the condition in a population presenting for dental care.  A companion Guide, “Bisphosphonate and Other Medication-Related Jaw Necrosis Part 2 – Clinical Management” will outline the strategies dentists should employ for patients with MRONJ.  It is suggested that Part 1 be thoroughly reviewed by the clinician before reading Part 2.

Part 2: Clinical Management (6th Edition)

A companion Guide, “Bisphosphonate and Other Medicated-Related Jaw Necrosis Part 1 – Background, Incidence and Risk Factors” discussed the pathogenesis of bisphosphonate and other medication-related osteonecrosis of the jaws (MRONJ) and the risk factors responsible for initiating the condition. It is suggested that Part 1 be thoroughly reviewed by the clinician before reading Part 2. This sixth edition Guide discusses the clinical presentation of MRONJ, presents a stage-specific management system for patients with MRONJ, and through a four-year longitudinal case report, presents the clinical intraoral sequela of MRONJ.

Human Papilloma Virus (HPV) has emerged as a significant risk factor and is changing the epidemiology of oral cancer that occurs in the oropharynx. Since 1988, the prevalence of oral cancers associated with the traditional risk factors of smoking and drinking alcohol has decreased by 50% whereas the prevalence of those in the oropharynx associated with HPV infection has increased by 225%. It is estimated that over 50% of all oral cancers will be HPV-related by 2030. This Quality Resource Guide (QRG) discusses the epidemiology, prevention, and dental considerations for HPV-associated oral cancer. It describes the principles of a thorough exam necessary to discover HIV-associated pharyngeal cancer, and appropriate referral if warranted. The dental team’s role in the education of young men and women, and their parents, about HPV infection and preventive vaccines is also covered. Detailed tables will serve as a quick reference for the dentist when evaluating suspicious symptoms occurring in the oropharynx and for the dental team when discussing HPV vaccination with patients and parents. This QRG will serve as an important resource for the dentist, and members of the office staff, as they assist with management of this rapidly increasing oral health dilemma.

General dentists often encounter patients with intraoral lesions or unusual intraoral conditions. This evidence-based Quality Resource Guide briefly reviews many common lesions and conditions typically discovered in a general dentistry practice. The QRG discusses the disorders' signs, symptoms, etiopathology and clinical features, including color images to assist the clinician in identification. Predisposing risk factors, specific therapeutic prescriptions and appropriate supportive measures are introduced to optimize the possibility of successful outcomes. Indications for referral are included for those situations that require the expertise of a specialized healthcare provider. The QRG provides all dental staff members with information to understand better the common lesions and conditions that can arise in the oral cavity. It is also an essential resource for the provider to assess and manage patients with intraoral lesions.