Bone strengthening pills linked to jaw bone damage

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.

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