Fosamax and Osteonecrosis of the Jaw
Osteoporosis and other diseases related to bone mineral density problems have been famously prescribed with a medicine belonging to the biphosphonate group called Fosamax. But current things seem bad for this drug as a many patients have reported about it causing osteonecrosis of the jaw (ONJ). This has made a New York dentist to addressed questions about Fosamax and dental health in a leading newspaper.
Osteonecrosis of the jaw is a serious bone condition affecting the jaws, involving the maxilla and the mandible. The impedance of the supply of blood or ischemia to a certain bone tissue, results in a damage which may eventually lead to the death on the areas of the jaw bone. By and large, it the dentists who first detect ONJ after a dental surgical procedure such as tooth extraction.
As what everyone was informend, the incidence of osteonecrosis of the jaw due to the use of biphosphonates like Fosamax is very small and insignificant. On the other hand, the Journal of the American Dental Association draw out a study that reveals that 4% of patients using Fosamax, even the oral forms, may develop ONJ.
Although it may occur asymptomatically, among the early signs of ONJ are loose teeth and exposed bone. There may also be pain on the jaw or gum as well as swelling or infection and dramatic gum loss. However, the most definitive sign of the osteonecrosis of the jaw is the exposure of mandibular and/or maxillary bone through lesions in the gingival area that do not heal.
The regimen for ONJ would depend on the etiology or the cause of the disease and the severity of the disease process. Medical management of the biphosphonate-related ONJ is comprises oral antimicrobial cleanses, systemic anti-infectives, systemic and topical antifungals, withdrawal from the biphosphonate therapy and refraining from any dental operations.
Unfortunately for the patients with ONJ associated with biphosphonates like Fosamax, the response to surgical intervention is relatively poor due to the impaired ability of the bone to heal. Careful excision of the dead, devitalized bone, analgesic, and other nonsurgical approach to treat ONJ are more favored than belligerent surgical measures for this type. Early diagnosis and treatment of ONJ is the key to avoid the irreversible bone collapse which may lead to the facial disfigurement of the patient.
As bothering as it seems, before deciding to cease your Fosamax therapy, you will need to inform your doctor about your plan. Moreover, the drug is also known to cause other adverse effects such as Fosamax femur fractures.
References:
merckmanuals.com/home/bone_joint_and_muscle_disorders/osteonecrosis/osteonecrosis.html?qt=&sc=&alt=
huffingtonpost.com/thomas-p-connelly-dds/forsamax-dental-work_b_1146395.html
