Fosamax - Dental Professionals Concerned about ONJ

Denver, COFosamax, made by Merck, was approved to help people suffering from Osteoporosis, a disease in which people lose bone mass and density which can result in bones that break easily. However, many people who have taken Fosamax have reported another problem, Osteonecrosis of the Jaw (ONJ).

It was around five years ago that dentists and oral surgeons began to notice that people taking Fosamax had a higher rate of ONJ. Since that time, dentists and oral surgeons have become increasingly concerned about the link between Fosamax and ONJ. They are concerned enough that the American Association of Endodontists (root canal specialists) has issued a statement warning dental surgeons to find out whether or not patients take Fosamax before working on their teeth.

In releasing its statement the association noted that all patients taking bisphosphonates should be considered to be at risk.

According to a report in the Los Angeles Times (April 3, 2006 found online at the American Association of Endodontists), since 2001 more than 2,400 patients who took Fosamax and other bisphosphonates have suffered from ONJ. Most of the cases of ONJ occurred after minor trauma to the jaw, such as a tooth extraction. In addition to this, 120 people who took the drugs in pill form have suffered major bone, joint, or muscle pain resulting in the patients requiring bed rest or aids for mobility.

Although the number of people who suffer from ONJ may seem small compared with the number who take Fosamax, there is a good chance that there are more people suffering from the condition. Many drug side effects are never reported, so there is a high possibility that many more people have developed ONJ but not come forward.

So far, the majority of cases of ONJ are appearing in patients who take bisphosphonates intravenously to offset some of the effects of cancer. ONJ is only treatable, so patients who develop it can only prevent it from spreading, they cannot reverse the effects. Furthermore, there is currently no way of identifying risk factors associated with developing ONJ, so it is impossible to tell who will and will not develop it.

The Academy of General Dentistry released a statement (December 19, 2006) that it is hopeful a new study by the Practitioners Engaged in Applied Research and Learning (PEARL) and the New York State Academy of General Dentistry (NYSAGD) will shed some light on the subject. The aims of the study are to determine the prevalence and risk factors of ONJ. Results from the study could still be a long time coming.

In another article, the Academy of General Dentistry noted that dentists should create 10-year treatment plans for patients who require bisphosphonates. "The patient should have all abscessed and nonrestorable teeth and involved periodontal tissues removed, all necessary endodontic procedures and restorative dental work performed, and dentures should be inspected to ensure a proper fit. Additionally, patients should be educated on the importance of good dental hygiene to reduce the probability that they will need restorative dental work once bisphosphonates therapy has commenced." For patients who have already started bisphosphonates, the best route is to not have dental surgery.