Best remedy… See your dentist first
Many lifesaving drugs have negative side effects but remain on the market because the benefits heavily outweigh the risks. Recently, it has been revealed that bisphosphonate drugs like Fosamax can produce a rare but serious and untreatable side effect in which the jawbone is unable to heal after dental extractions and periodontal surgery. This side effect can be very dangerous and is called osteonecrosis of the jaw or ONJ.
How bisphosphonates work
It is thought that bisphosphonates bind the bone so it will not be subject to deterioration in medical conditions such as osteoporosis. That’s a good thing. But in rare instances, the raw, exposed bone becomes necrotic and never heals. Granted, ONJ is a rare side effect but for whoever gets it, it is 100 percent.
Bone is living tissue
In dental school, I was amazed to learn that healthy bone was actually alive and in a constant state of motion. It can do all kinds of tricks like tearing itself down and then rebuilding in a different place. That’s how braces work. Braces put a constant force on a tooth, pulling or pushing in a specified direction. Then the root of a tooth puts pressure on the bone, cells called osteoclasts eat away the bone creating a space the tooth can move into.
This movement creates a void on the opposite side of the root. The body hates a vacuum so another type of special cell called osteoblasts creates new bone to fill in the area. Basically, the same principle applies when a tooth is extracted. New bone is created to fill the void where the roots and tooth used to be. Understanding this it becomes very clear that ONJ is a serious condition and that it’s important to educate yourself on the risks of bisphosphonate type drugs.
What to do
Prevention is always the best treatment and in the case of bisphosphonate induced ONJ it is the only answer. Patients must be dentally healthy prior to taking the bisphosphonate type drugs or medicine. The best way for this to happen is for physicians to insist patients see their dentist prior to prescribing the drug. This way, bad teeth and gum disease can be treated before the medicine has a chance to change bone behavior.
If you have been taking this type of medicine, you need to advise your dentist and communicate your concerns to your physician. If you haven’t been for a dental checkup in a long time, it is time to make that phone call.