Fosamax: Update Your Warnings

Sacramento, CAFor many post-menopausal women, doctors routinely prescribed hormone replacement therapy (HRT) and Fosamax, a drug that allegedly helps prevent and reverse osteoporosis, or bone loss. The 'major side effects' listed on the Fosamax website are nausea and indigestion -jaw bone loss and dental decay should also be added to the list of side effects, according to sufferers like Dorothy Martz.

Years after HRT was prescribed like aspirin, we know about those lethal side effects, but what about Fosamax? Interestingly, even though the Fosamax website goes on to say that "If you develop severe bone, joint, and/or muscle pain at any time, contact your doctor," it also advises to continue Fosamax to reverse bone loss.

The dental community would disagree. It has begun to realize an association between the use of bisphosphonates - including Fosamax (also known as alendronate) - and osteonecrosis (necrosis, or bone death) of the jaw. BON - Bisphosphonate-associated osteonecrosis - is the acronym given to the symptoms associated with IV bisphosphonate use. BON symptoms include jaw bone pain, loosening of teeth, exposed bone, periodontal infections, and delayed tissue and bone healing.

"My doctor put me on Fosamax in February, 2002 because it was supposed to help my osteoporosis," says Dorothy Martz. "I wasn't taking any other medications and it wasn't long after taking Fosamax that I started to have breathing problems. Then my gums started to swell and there was a soreness in my jaw, near my right ear." Dorothy visited her dentist and she had a panorex x-ray, the kind that takes an x-ray of your entire jaw. To her shock, he told her that she needed major periodontal work and two root canals followed by two crowns - due to bone recession. She never had dental problems in the past.

Currently, there is no effective treatment to stop the progression of bisphosphonate bone death associated with BON. According to the Royal Adelaide Hospital in Australia, "Discomfort may be eliminated with long-term antibiotic coverage and Peridex Rinse." The hospital refers patients to oral surgeons but surgery is difficult as it often exposes further bone and because bisphosphonates such as Fosamax affect the whole skeleton, "locating viable bone margins may be impossible... Furthermore, removal of painful teeth, while initially alleviating pain, also further exposes bone, causing more pain." Isn't it about time Fosamax added this information to their website?