Bevacizumab

Oral health effects

• MRONJ (antiangiogenic)

  Antiangiogenic agents are independently associated with osteonecrosis of the jaw, and additively so with antiresorptives.

  Mechanism: Reduced angiogenesis impairs bone/soft-tissue healing.

  Clinical management: Apply MRONJ precautions: complete invasive work beforehand where possible, atraumatic technique, prompt referral.

• Impaired wound healing / bleeding

  VEGF inhibition delays healing and can increase bleeding.

  Clinical management: Coordinate timing of surgery with oncology.

• Taste change (dysgeusia)

  Taste alteration is among the most common adverse reactions (incidence >10%) with bevacizumab across clinical studies (label).

  Clinical management: Reassure that taste changes are common during cancer therapy and usually improve after treatment; rule out oral candidiasis and dry mouth, keep the mouth clean (bland rinses), and suggest dietitian input if eating is affected.