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Oral Biphosphonates

Osteonecrosis of the Jaw

Recent news reports have alarmed and confused people who take bisphosphonates to prevent or treat osteoporosis. That's because a condition known as osteonecrosis of the jaw (ONJ) has been reported in some patients who have taken these medications. The true risk posed by oral bisphosphonates remains uncertain, but researchers agree that it appears to be very small.

Examples of oral bisphophonates include:

  • alendronate (Fosamax)
  • risendronate (Actonel)
  • ibandronate (Boniva)

Bisphophonate-associated osteonecrosis of the jaw, or BON, is a rare but serious condition that can cause severe damage to the jawbone. BON is diagnosed in a patient: 1) who has an area of exposed bone in the jaw that persists for more that 8 weeks, and 2) who has no history of radiation therapy to the head and neck, and 3) who is taking, or has taken, a bisphosphonate medication

The overwhelming majority (94 percent) of people diagnosed with BON are cancer patients who are receiving or did receive repeat high doses of bisphosphonate through an intravenous (IV) infusion.

The ADA believes that your doctor and/or healthcare provider is the best source of information regarding your need for bisphosphonate medications. You should not stop taking these medications without speaking to your doctor or other healthcare provider. If you have osteoporosis or are at high risk for bone breaks, the benefits of these medications greatly out weigh the low risk of developing BON. Presently, there is no known prevention for BON. However, regular dental visits and excellent oral hygiene practices may be the best ways to reduce your risk

Resources: The American Dental Association

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