JAW DEATH---something you don’t want to get

Posted by Dr. Edward Magida | Filed under , , , , ,

Many women, as they age, develop post menopausal osteoporosis. This is a condition characterized by a decrease in bone mass and density. As a result of this condition, their bones become fragile and break more easily. In order to prevent this chain of events from happening, doctors prescribe a class of drug known as biphosphonates, and the most popular oral version is called Fosamax. It is actually the 13th most prescribed drug in the U.S. The way the drug works is by altering the way the bone cells make new bone. While the drug helps prevent fractures in the spine or the hip, which could be devastating, it apparently causes problems in the jawbones.  There is the possibility of inhibiting new blood vessel formation, which can interfere with healing after the extraction of a tooth. Some patients, after an extraction, do not heal. Exposed bone is the result of the extraction and this can become infected and very painful and there is no way to treat the problem. The technical term for the problem is called osteonecrosis.

The popular name given to the problem is called jaw death. Most cases of jaw death have occurred in cancer patients who have taken intravenous bisphosphonates, which is one of the drugs given to cancer patients to reduce the incidence of cancer induced bone fractures. There needs to be more research done about whether the oral versions of the drug have the same incidence of problems. What this means is that any person who will be going on the drug needs to have a thorough clinical and radiological (xray) examination done of their teeth and mouth before they are started on the drug. If any dental treatment such as extractions or dental implants are needed, these should be accomplished before the drug regimen is begun. Routine cleanings, fillings root canals and crowns do not cause the associated problems. As to why the jawbone responds negatively to this drug, no one is really sure. So if you are taking this type of drug, please be sure to tell your dentist before treatment is started.

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