What dental procedure can be performed without consulting a physician for a patient on bisphosphonates?

• A. Endodontic therapy
• B. Prophylaxis and scaling
• C. Extraction
• D. Occlusal restoration

Answer: (D)

In the context of dental procedures for patients on bisphosphonates, occlusal restorations are generally considered to pose a lower risk. This is largely because they are minimally invasive procedures aimed at restoring tooth function and structure without requiring manipulation of soft tissues or bone, which can be more problematic in bisphosphonate patients due to the risk of osteonecrosis of the jaw.

Osteonecrosis is a significant concern for patients on bisphosphonates, particularly with invasive procedures like extractions or implant placements. These procedures can lead to complications, necessitating consultation with a physician to assess the risks versus benefits.

In contrast, while procedures like endodontic therapy and scaling also have their own risk considerations, they often involve deeper engagement with the dental structures and surrounding tissues that might raise concerns in bisphosphonate patients. Prophylaxis and scaling can sometimes cause gum trauma, while endodontic therapy can carry risks of complications related to the surrounding bone.

Thus, for a straightforward and less invasive procedure that doesn't typically escalate the patient's risk profile significantly in relation to bisphosphonate therapy, an occlusal restoration is appropriate to perform without the need for a physician's consultation. This makes it a suitable option for treating such patients