Osteonecrosis of the Jaw

Osteonecrosis means “areas of dead bone.” It can occur in one or more bones, quite frequently the knee of hip, as a result of treatment with cortisone-like drugs such as prednisone, or after an injury. Osteonecrosis of the jaw (ONJ) is a debilitating bone disease which affects the maxilla- and the mandible- areas of the jaw. Several different forms of ONJ have been reported for more than a century, along with a number of causes suggested in the literature. But did you know –

1. ONJ was first discovered in Florida among a population of patients who were taking bisphosphonate (or bone-strengthening) drugs, required by some cancer treatment regimens as well as treatment for osteoporosis.
2. It is difficult to explain and understand why a drug that strengthens your bones could destroy your jaw.
3. Bisphosphonate drugs remain in the body for at least ten years after discontinuation.

According to the the Osteogenesis Imperfecta (OI) Foundation, if you are being treated with bisphosphonates or will begin a bisphosphonate treatment, make sure you inform your dentist about the treatment. They also recommend the following as preventive measures for ONJ –

•  The best way to lower risk of ONJ is through proper oral hygiene along with routine dental visits to prevent infections or periodontal (gum) disease
• Regular cleanings by the dentist should be performed with careful attention paid to avoiding soft-tissue injuries
• Dentures should be examined carefully to minimize their potential for soft-tissue injury and adjusted if required
• Dental surgery should be scheduled prior to starting a bisphosphonate therapy, or, if possible, stop  bisphosphonate treatment for several months before dental surgery, and resume only after the surgical area is healed.
• Begin a course of antibiotics prior to dental surgery
• Seek the care of a doctor who specializes in metabolic bone disorders and is knowledgeable about bisphosphonates therapy and their potential side effects.

 

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