The first report of jaw osteonecrosis in patients treated with bisphophonates was published in 2003. Since then, not a week goes by without new cases being described in the literature. The vast majority of patients treated with IV bisphosphonates are oncology patients, although numbers of patients with osteonecrosis treated for osteoporosis and Paget's disease are also rising. In the absence of any established treatment, it is generally agreed that initiating pretherapeutic prevention strategies in oncology patients is advisable. Treatment of a recognised osteonecrosis is discussed, with preference being given for a conservative approach rather than aggressive surgical procedures. Our team suggests classifying affected patients into two categories according to the lesions: disabling or non-disabling. An appropriate treatment plan can then be put into place.