NEW YORK (Reuters Health) - It has been known for a while that injections
of a class of anti-osteoporosis drugs might trigger jaw bone decay after certain
dental procedures, and now it seems that pill forms of the so-called
bisphosphonate medications could have the same side effect.
Specifically, a study conducted at the University of Southern California School
of Dentistry in Los Angeles found that oral treatment with alendronate (more
familiar as Fosamax) for as little as a year increases the risk for the jaw bone
disease after a tooth extraction or other dental problem.
Dr. Parish P. Sedghizadeh and colleagues report the finding in the Journal of
the American Dental Association.
Sedghizadeh's team analyzed electronic medical records at their institution and
found that, of 208 patients who had taken alendronate pills, nine (4 percent)
had active jaw bone decay, or osetonecrosis. All the affected patients were
women, ranging in age from 63 to 80, who had taken 70 milligrams of alendronate
once per week for 12 to 120 months.
"We've been told that the risk with oral bisphosphonates is negligible, but four
percent is not negligible," Sedghizadeh said in a press release.
Four cases developed following tooth extractions and five were associated with
denture-related ulcers.
By contrast, the problem was not seen among some 13,500 dental patients who had
not taken alendronate.
The researchers suggest that for patients taking a bisphosphonate, other
treatment options should be considered "for nonnecessary extractions." For
necessary extractions, "good oral hygiene should be achieved" first.
They recommend updating dental surgery consent forms, to warn patients on
bisphosphonate therapy that they may be at risk of developing osteonecrosis of
the jaw.
SOURCE: Journal of the American Dental Association, January 2009.
