connected to jawbone injury
The drugs to treat osteoporosis is not without
possible side effects, most notably a condition made p'blicda extensively in the
press that the tissue dies.
The thought absolutely puns,
Dr. Thomas B. Dodson explained, " 'Related of Bisphosphonate osteonecrosis
of the jaw' is a mouthful." His expertise is another mouthful - Oral and
maxillofacial surgery at Massachusetts Hospital. He is an expert. . .
Let's call it fair BRONJ.
The problem has been linked to drugs called bisphosphonates, 10 located in
sales in the U.S. among all categories of drugs, according to IMS Health,
which analyzes markets for pharmaceutical and health care. Most cases come
after someone has been treated for cancer with powerful and intravenous
forms of drugs. About 1 in 10 cancer patients treated with IV
bisphosphonate of the problem develops jaw.
But a handful of cases have appeared in women who take much smaller doses
of drugs to treat osteoporosis.
Bisphosphonates, sold as Actonel Ca, Aredia, Boniver, Didronel, Fosamax,
Fosamax Positive D, Reclast, Zometa and Skelid, meanings are to increase
bone density in the short term by reducing the portion of the bone-loss of
the life cycle of bone. But some scientists think that drugs could
eventually hurt the ability of the jaw to heal after, say, a tooth
extraction or dental grafting.
Estimates on the number of people who may experience the range of jaw
problem of 1 in 2,000 to as much as 1 in 300 people who take drugs for
In the U.S., 55 million prescriptions for bisphosphonates are written
annually, according to a 2007 report in the journal Osteoporosis
International. Even if not all of those prescriptions are filled, and even
if many of the women who begin taking the drug stopped, the number of
women who perhaps have the problem in dentists' chairs is safe climb.
Most of the commonly, these people will see or feel that a bone exposed in
the mouth, as the dead bone works its way by rubber or fabric, but without
the pain. In such cases, these people are just using an antibacterial
rinse. If there is pain or discomfort, and the area of exposed bone are
small, a dentist will try to smooth the exposed area.
In rare cases, the area of dead bone is large. "So people are at risk of
breaking the jaw, because the area is so big," Dodson said.
So why does a drug that circulates through the entire body has resulted in
a punch to the jaw pharmacist? Researchers have only theories.
It could be, Dodson said that in mandible bone metabolism at a faster rate
than in other parts of the body as more of the drug is deposited there.
And because there are more bacteria in the mouth and teeth area, that
could add to inflammation, worsening the problem.
Or it could be, he says, that the mechanism of the drug are at work.
Bisphosphonates inhibits the cells that dissolve bone. "But dissolve bone
is part of a healthy life cycle," he said. The natural balance between
bone-dissolving and making new bone is broken and the bone-producing cells
now dominate. But when they die away, there are fewer cells for cleaning
them, and they remain a dead body.
The dental procedures - the extraction of teeth, dental transplants, oral
surgery - may increase the risk of a problem because of trauma to the jaw.
That's why the American Assn. of Oral and Maxillofacial Surgeons recommend
that if a woman starts taking a drug for osteoporosis, she had the dental
work done before it begins.
If she has been taking the drug for three years or more, the association
recommends a vacation of the drug for three-months prior to having non-emergency
But for women who have been on drugs, an urgent problem - like a toothache
that late - should be dealt with immediately, although there may be a 1 in
300 chance that she has BRONJ.