Bone-building drugs (bisphosphonates) have been in the news a lot lately.  Bisphosphonate drugs taken orally, like Fosamax, Boniva and Actonel are proven to be quite effective in treating and preventing the progression of osteoporosis, and are taken by millions of people. Recently, bisphosphonates have been linked to a serious side effect called osteonecrosis of the jaw (ONJ).

Osteonecrosis is, plain and simple, dead bone.  In jaws, the condition presents itself as abscesses, exposed bone and loose teeth, and is often very painful.  The condition is not reversible, but can be controlled with antibiotics and, in some cases, surgery.  A recent medical study found that 60% of ONJ cases reviewed occurred after invasive dental procedures, such as tooth extraction.

 It seems strange that a drug used to help improve bone health could actually lead to bone death—at least in the jaw.  No one knows exactly why this occurs, but scientists do have a theory. They believe that because bisphosphonate drugs prevent too much bone loss by  “turning off” the cells that break down bone, any damaged or weak bone, more commonly found in the jaw, (from the higher than normal amount of stress and inflammation associated with teeth and gums) builds up and can lead to ONJ.

It’s important to note that the vast majority of these cases are linked to intravenous bisphosphonate treatment (drugs like Zometa and Aredia), used to treat bone cancer patients, with doses many times higher than those of oral drugs used for osteoporosis.  The risk of bone fracture cased by osteoporosis is much greater than the risk of developing ONJ from taking oral bisphosphonates, so it’s important to not stop taking this medication without consulting your physician.  It’s also important to let your dentist know if you are taking any of these drugs.  Good oral hygiene and regular dental cleanings, properly fitting dentures, and semi-annual exams, can prevent this and other, more common dental conditions, and help you keep your healthy smile for a lifetime.

Keep smiling!

---

Caron Nelson Glickman, DDS has been helping her patients achieve and maintain healthy smiles in Duvall since 1992.

          For more information, contact 425-788-1551.

          Caron Nelson Glickman,DDS
          26425 NE Allen Street, #102 • Duvall
          425-788-1551 • caronnelson@comcast.net
          www.great-smile.com