Oral Bisphosphonate Use Linked to Osteonecrosis of the Jaw

Four percent of patients at dental school with history of oral bisphosphonate use have jaw problem

11 jan 2009-- Osteonecrosis of the jaw may be more common in people who have used the oral bisphosphonate Fosamax than data has previously reported, especially following tooth extraction, according to an article published online Jan. 1 in the Journal of the American Dental Association.

Parish P. Sedghizadeh, D.D.S., of the University of Southern California in Los Angeles, and colleagues analyzed the USC School of Dentistry's electronic records system to identify patients with a history of Fosamax use, as well as patients on the drug being managed for active osteonecrosis of the jaw.

The authors found 208 patients with a history of Fosamax use. Of these, nine had active osteonecrosis of the jaw, which represented roughly 4 percent of Fosamax-using patients. Patients' ages ranged from 63 to 80; all were females who took the drug for at least 12 months for osteoporosis. All cases occurred after tooth extraction or denture trauma with exposure of bone, the report indicates.

"Current data like ours suggesting a risk of osteonecrosis of the jaw in oral bisphosphonate users has prompted us to actively screen every patient who comes to the school with updated consent and patient medical history forms reflecting the need for increased awareness and early risk or disease assessment. We have also updated our consent for dental surgery (e.g. extractions) with the American Dental Association recommended statement: 'Because you are taking a type of drug called bisphosphonate, you may be at risk of developing osteonecrosis (bone death) of the jaw and certain dental treatment may increase that risk,'" the authors write.

Abstract
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