Enhancing Oral Health Literacy to Prevent Medication-Related Osteonecrosis of the Jaw: Awareness and Compliance Among Breast Cancer Patients Receiving Bone-Modifying Agents.

This cross-sectional study evaluated awareness, knowledge, and compliance with oral health recommendations among 528 breast cancer patients receiving bone-modifying agents (BMAs) at Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC) between July 2021 and March 2025. Data were collected using a structured, validated, self-administered questionnaire assessing sociodemographic and clinical characteristics, knowledge of medication-related osteonecrosis of the jaw (MRONJ), adherence to oral health guidance, dental referral practices, and oral hygiene behaviours. Among 266 respondents, the cohort was predominantly female (97%), aged 41–60 years (60%). Overall, 56% of the participants reported awareness of MRONJ, 73% adhered to extraction avoidance, and 70% rated oral hygiene as highly important. Compliance was significantly higher among female patients, and those receiving their first BMA dose at SQCCCRC (84% vs. 69%, p = 0.009). Awareness of extraction avoidance was strongly associated with adherence (p = 0.002), whereas MRONJ awareness alone was not. Hospital records indicated that 86.5% of patients underwent baseline dental assessments before or during therapy. Oral hygiene practices were generally positive, although only 30% combined brushing with flossing, and a minority reported oral pain (11%) or infection (8.3%). The geographical location did not significantly affect awareness or compliance. These findings highlight the critical role of structured institutional education, baseline dental evaluation, and patient education in promoting adherence to preventive oral health measures. Integrating these interventions into oncology care pathways can enhance patient awareness, support preventive behaviours, and reduce the risk of MRONJ in breast cancer patients receiving BMA.