Jaw Osteonecrosis and bisphosphonates
The Link between Jaw osteonecrosis and the use of bisphosphonates
One of the things that puts many people off the use of bisphosphonates such as Fosamax, Actonel and Boniva is its association with jaw osteonecrosis.
If you have had recent major dental surgery and/or are suffering from metastatic carcinoma or multiple myeloma then you should have a long discussion with your doctor as to whether you should take oral bisphosphonates to treat osteoporosis. It is worth considering the use of other medications and/or natural treatments due to the risk of osteonecrosis of the jaw.
If you and your doctor feel that it is necessary for you to take bisphosphonates to treat osteoporosis then it is very important that you get a full dental examination before taking oral bisphosphonates such as Fosamax, Actonel or Boniva. Once you are taking your prescribed course you should not receive any dental surgery unless it is an emergency.
Why does jaw osteonecrosis occur
It is thought that osteonecrosis of the jaw is a result of over suppression of osteoclast activity when taking bisphosphonates. These osteoclasts are involved in the bone remodeling cycle.
Risk of developing osteonecrosis of the jaw
The actual risk of developing jaw osteonecrosis is low at about 0.7 cases per 100,000 person years of exposure. The risks of developing osteonecrosis are much higher in people who have received recent dental treatment and people with cancers; especially those taking corticosteroids or chemotherapy for treatment of the condition.
ReferencesMayes (2007) Review of post menopausal osteoporosis pharmacology. Nutr. Clin. Prac. 22:3: 276 to 285
(2006) Dental management of patients receiving oral bisphosphonate : expert panel recommendations. Am Dent Assoc. :1144–1150.
Woo et al (2006) Narrative [corrected] review:and osteonecrosis of the jaws. Intern Med. : 753 to 761.