Bisphosphonate and Osteonecrosis of the Jaw

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Introduction

Osteonecrosis of the jaw is a rare condition that can be caused by bisphosphonate medication.  It is a serious disorder that causes severe bone destruction or loss.  Osteonecrosis of the jaw may be treated with antibiotic rinses, removable mouth pieces, and minor dental work.

Osteonecrosis of the jaw occurs in a small number of people that take bisphosphonate medication.  Oral bisphosphonate medication is used to prevent or treat osteoporosis and Paget’s disease, two types of bone thinning diseases.  Intravenous bisphosphonate medication is used in cancer treatment.  It can reduce bone pain and hypercalcemia, high calcium levels in the blood caused by some types of cancer.  The risk for osteonecrosis is higher for people with cancer that are receiving intravenous bisphosphonate than for people receiving oral bisphosphonate.

The risk for osteonecrosis of the jaw appears to be higher for people that have dental surgery or invasive dental procedures, such as tooth extraction, while taking bisphosphonate medication.  However, the condition can also occur on its own during the period that bisphosphonate medication is used.  The risk for developing the condition is lower among people that have non-invasive dental procedures, such as root canals, cleanings, and fillings, after taking the medication.

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Symptoms

You may be at risk for developing osteonecrosis of the jaw if you presently take bisphosphonate medication or have received it in the past year.  Symptoms of osteonecrosis include pain, swelling, and jaw infection.  Your jaw may feel numb or heavy.  You may have loose teeth.  Gum infections may not heal well.  You may have drainage or exposed bone.
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Diagnosis

Your dentist or doctor can diagnose osteonecrosis of the jaw by reviewing your medical history, prescription history, and dental history.  Your dentist will examine your mouth, jaws, gums, and teeth.  X-rays may be used to provide more information.  You may be tested for infection.
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Treatment

Osteonecrosis of the jaw is treated with excellent oral hygiene and professional care.  Professional treatments may include antibiotic rinses, removable mouth pieces, and minor dental work.  Surgery is not recommended because it may make the condition worse.  Minor dental work may include removing decayed tissue and smoothing damaged bone.  People that need to take bisphosphonate medication should not plan dental work during the period of prescription treatment.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.