Bisphosphonates and jawbone infections | Is Your Jaw Safe

Bisphosphonate treatment for osteoporosis is becoming popular. Unfortunately, having jawbone infections while taking bisphosphonates is dangerous. This medicine doesn’t cause infections. The medicine makes it difficult to fight an infection that has already started. One side effect of using this medicine is decreased capillary flow in your bones. A decreased blood flow reduces a person’s ability to heal bone infections. The jawbones are the most likely bones in the body to get infections. Infections here can be common without regular dental care. It is important to regularly rule out and minimize dental problems during bisphosphonate use.

Bisphosphonate Therapy

Patients can take bisphosphonates orally or intravenously to treat bone loss or osteoporosis. The drug becomes part of osteoclasts that eat away at bone and stops them in their tracks. Bisphosphonates have also proven effective for bone cancer patients taking chemotherapy drugs. Overall, the drug can improve bone density and stop bone deterioration. Yet, it is believed that bisphosphonates have a side effect of reducing blood flow to bone.

The inability to fight jawbone infections will lead to osteonecrosis

Osteonecrosis means dying bone. Osteonecrosis of the jawbones (ONJ) never just occurs on its own. There must be some type of infection that started from some other cause. ONJ is caused by a lack of blood in the jaw area. Due to the diminished blood supply, the infection grows and starts killing the bone. You usually find out you have Osteonecrosis of the Jaw after a tooth extraction. The area of dead bone heals slowly and can be painful to the touch. This is much more common when Post-menopausal osteopenic and osteoporotic women are prescribed Bisphosphonates to strengthen their bones.

Causes of osteonecrosis

A recent review of decades of research on ONJ has shown that those people taking certain drugs for osteoporosis, anticancer drugs, or glucocorticoids have an increased risk of developing ONJ. This includes people who receive frequent high doses of bisphosphonates (which can be found in anticancer and osteoporosis medications) over an extended period of time, who also have:

Bisphosphonate use is a risk factor for osteonecrosis of bone

Dead or dying jawbone exposed for longer than eight weeks is considered very dangerous. It can be identified by clear indicators like exposed bone and loose teeth. Patients who are given bisphosphonates intravenously are more likely to have these long term infections. The disease progresses through three stages:

  1. Includes exposed bone.
  2. Additionally brings inflamed or infected bone or surrounding soft tissue.
  3. Identified by fractured bone in addition to infection. BRONJ can be prevented with good oral health and self-checks for possible signs of the disease. Avoiding long term or extensive use of bisphosphonates also may prevent these devastating infections.

Prevention strategies for at-risk individuals having bisphosphonate therapy include

These things can reduce the risk:

  • Antibiotics
  • Surgical procedures to remove dead or exposed bone
  • Teriparatide
  • Bone marrow stem cell transplants
  • Laser therapy

Learn more about bisphosphonate use causing major jawbone infections

There is a clear connection between bisphosphonates and jawbone infections. As we grow older, bone deterioration is something to begin thinking about. Ways of strengthening bones offer long lasting solutions but may bring undesirable side effects. Dental infections can be a big problem with bisphosphonate use.

The use of bisphosphonates to help produce bone greatly helps patients dealing with bone problems, but may lead to Bisphosphonate Related Osteonecrosis of the Jaw (BRONJ) in some cases. Dr. James Fondriest, explores BRONJ, its possible cause, and its treatment.

Aside from providing dependable general and restorative dentistry services to our community, Dr. James Fondriest also holds respected academic appointments at the Pankey Institute in Key Biscayne, FL, and the Spear Institute in Scottsdale, AZ, and he is a former Associate Professor in the Department of Prosthodontics at the University of Florida Dental School. At Lake Forest Dental Arts, Dr. Fondriest combines his impressive array of experience with modern technology and caring, compassionate, knowledgeable staff, and we proudly serve patients from Lake Forest, Lake Bluff, and all surrounding communities. To schedule a consultation, call our office today at (847) 234-0517.