Fosamax and ONJ: Not much is Known about the Link

Denver, COFosamax, a drug taken for osteoporosis, has recently been linked to osteonecrosis of the jaw (ONJ). Dentists have confirmed they are seeing increasing cases of ONJ in patients and some doctors are also reporting increasing incidents.

However, not much is known about the link between Fosamax and ONJ.

According to an article in the New York Times, the actual number of people suffering from osteonecrosis of the jaw is not known. Some experts estimate that between 1 and 10 percent of patients taking bisphosphonates to protect their bones may develop ONJ. The incidence is likely higher in patients who take bisphosphonates intravenously to protect their bones from cancer than it is in patients with osteoporosis who take the drugs in pill form, but it's not yet clear what the difference in incidence is.

Unfortunately, not a lot of research has been done about the link between bisphosphonates such as Fosamax and osteonecrosis of the jaw. The problem is that patients taking Fosamax and other bisphosphonates are left with a lot of questions regarding what they should and should not do while taking their medications. Furthermore, it is unclear how long after ceasing medication the risk of ONJ remains.

Fosamax was approved by the U.S. Food and Drug Administration in 1995 for the prevention and treatment of osteoporosis and Paget's disease. A 2004 study done by the Long Island Jewish Medical Center showed a link between the use of Fosamax and the incidence of ONJ. Further evidence of a link between the two was published in the Journal of Oral and Maxillofacial Surgeons.

Osteonecrosis of the jaw is a condition in which the bone tissue in the jaw does not heal after even minor traumas. This occurs because blood supply to the bone is either temporarily or permanently cut off; bone tissue is living and requires blood in order to remain alive. Often, people suffering from ONJ require long-term antibiotic therapy or surgery to remove the dying bone tissue. Symptoms of ONJ include unusual sores in the mouth, exposed bone, loose teeth, infection, pain or swelling in the gums, strange sensation in the jaw, drainage, tingling, burning or pain in the jaw, and numbness or heavy sensation in the jaw.

Patients who are taking Fosamax and require some form of dental surgery, such as an extraction, should speak with their doctors about the risk of osteonecrosis of the jaw. If at all possible, have any necessary dental work done before beginning Fosamax treatments. Even minor dental trauma can lead to ONJ. If you are having dental work done while taking Fosamax, make sure your dentist knows you are taking the drug.

Some lawsuits have been filed against Merck, maker of Fosamax, alleging that Merck knew about the link between Fosamax and ONJ but did not warn consumers about this risk.