Bisphosphonates, a class of medications used to treat osteoporosis and advanced cancers that have spread to the bone, have been linked to osteonecrosis of the jaw (ONJ), a condition that denotes the death of jaw bone tissue. Popular bisphosphonates include Fosamax, Boniva, Zometa and Actonel. These drugs have become some of the most widely prescribed medications throughout the world. Merck’s Fosamax recorded sales of $3.2 billion in 2005 and over 22 million prescriptions written in the United States alone, according to IMS Health. It is estimated that over 2,400 Fosamax patients have reported serious jaw bone problems, including osteonecrosis of the jaw, since 2001.
Around the same time, Dr. Ruggiero, a maxillofacial surgeon at Long Island Jewish Hospital, noticed that numerous osteoporosis patients taking bisphosphonates had developed osteonecrosis of the jaw. In 2004, he published a report on 63 patients diagnosed with the condition; 56 had cancer and seven had osteoporosis. The number of reported cases is still quite small, but because bisphosphonates stay in the bone for a long period of time, some researchers expect the number of cases to increase dramatically.
Symptoms of osteonecrosis of the jaw include: pain, swelling, gum infections, drainage, jaw infections, loose teeth, jaw numbness, and exposed bone. The American Dental Association recommends notifying your physician or dentist immediately if you have taken a bisphosphonate medication and experienced any of these symptoms. The ADA also recommends that patients tell their physicians and dentists that they are taking bisphosphonate medications before any dental work is performed.