October 2008

Osteoporosis drugs can 'kill' jawbone

Medical doctors often prescribe bisphosphonates for osteoporosis as well as certain cancers, and usage has been increasing due to large-scale marketing and advertising to consumers.

Taken orally, these medications (such as Boniva or Fosamax) are aimed at promoting bone density in women with osteoporosis, and taken intravenously, are supposed to help stop the spread of cancer in chemotherapy patients. However, the use of bisphosphonates has also been linked to osteonecrosis of the jaw, more commonly known as "dead jaw."

Osteonecrosis occurs when part of the jawbone essentially dies and becomes exposed. The disease is more prevalent among patients who receive bisphosphonates through an IV, but researchers are now expressing concern about patients who take the oral form.

"This is a very complex issue, and our understanding of it continues to grow," said Jon Suzuki, DDS, PhD, MBA, professor and director of the graduate program in periodontology at Temple University's Maurice H. Kornberg School of Dentistry. "Both dental and medical professionals need to maintain open lines of communication with each other to ensure the best care for their patients who are taking bisphosphonates."

Existing research suggests that taking these medications orally for more than three years or intravenously for more than six months could disturb the balance between bone cells that produce calcium and those that remove calcium. This condition can lead to oral health problems including loose teeth, jaw and gum pain, swelling and infection, numbness and gum loss.

Patients who have existing dental problems or have just had dental work and are taking bisphosphonates are also at higher risk for osteonecrosis.

SOURCE: "Bone Meds Could Have Side Effects with Bite," Temple University, Aug. 2008.