Be Aware if You Take Bisphosphonates
Scientists are investigating a possible connection between the death of bone tissue (osteonecrosis) of the jaw and medications known as bisphosphonates. Bisphosphonates are commonly used to treat and prevent osteoporosis and to treat bone pain in cancer patients. Thus far, no clear cause-and-effect relationship has been established, and scientists are unsure why some patients develop osteonecrosis of the jaw. But there are good reasons to suspect that bisphosphonates play a role.
Cases in which people taking bisphosphonates experienced osteonecrosis first began surfacing in 2003. The vast majority of cases—about 94 percent—have involved cancer patients receiving intravenous drugs such as pamidronate (Aredia), clodronate (Bonefos), and zoledronic acid (Zometa).
But this side effect also has been reported, with much lower frequency, in patients taking oral bisphosphonates such as alendronate (Fosamax), risedronate (Actonel), and ibandronate (Boniva) for osteoporosis.
How common is this problem? Small studies have found that about 10 percent of patients with multiple myeloma (cancer of the plasma cells) treated with bisphosphonates are affected, as are nearly as many breast cancer patients who took these medications. Meanwhile, the American Dental Association has estimated that there will be about seven cases per year of osteonecrosis for every million people taking oral bisphosphonates.
Many of the reported cases occurred after dental surgery to treat infections, such as getting a tooth pulled. Before you start taking a bisphosphonate, it’s a good idea to have a dental exam and complete any necessary extractions or implants. If you are already taking a bisphosphonate, tell your dentist so she or he can consider it in planning your treatment. Also, be aware of the symptoms of osteonecrosis, which include pain, swelling, or infection of the gums or jaw; gums that aren’t healing; loose teeth; and numbness in the jaw.
Source: Dental Health for Adults: A Guide to Protecting Your Teeth and Gums. Copyright © by Harvard University. All rights reserved.