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Keywords: OSTEOPOROSIS, OSTEONECROSIS, JAW, ENDODONTICS, BISPHOSPHONATES
Source: Edelman PR, Chicago 	  	
Released: Wed 28-Sep-2005, 07:00 ET
http://www.newswise.com/articles/view/514901/?sc=dwhp

Critical Information for Patients About Possible Side Effect of 
Bisphosphonates

Newswise — An article titled, “Bisphosphonate-associated Osteonecrosis 
of the Jaws and Endodontic Treatment: Two Case Reports,” in the October 
issue of the Journal of Endodontics (JOE), a publication of the American 
Association of Endodontists (AAE), suggests patients using 
bisphosphonates as part of their cancer treatment and for debilitating 
bone diseases, such as osteoporosis and Paget’s disease, may be at risk 
of experiencing a painful, disfiguring condition known as osteonecrosis 
of the jaw, a disease that leads to the breakdown of the bone. The word 
osteonecrosis literally means “death of bone” (osteo = bone, necrosis = 
death).

Initial symptoms include burning, tingling or localized pain in the jaw, 
and may lead to more serious complications, such as infections and 
jawbone degeneration. Patients who think they may be experiencing 
symptoms of osteonecrosis of the jaw should seek counsel from their 
general physicians and oncologists, and inform their dentists, 
endodontists and other dental professionals that they are undergoing 
treatment with bisphophonates.

The latest generation of bisphosphonates includes: alendronate 
(Fosamax®); pamidronate (Aredia®); and zoledronate (Zometa®). 
Bisphosphonates help strengthen bone and prevent fractures in the hip, 
spine and other skeletal regions by inhibiting bone loss.

The article indicates that at the same time bisphosphonates support the 
buildup of bone in areas weakened by disease or as a side effect of 
treatment, some patients taking bisphosphonates may experience the 
opposite effect in the lower and upper jawbones. “Considering the large 
number of patients around the world using bisphosphonates for prevention 
or treatment of osteoporosis, dentists may be dealing with a significant 
potential complication,” write the authors.

Written by Aaron P. Sarathy, D.M.D., Sidney L. Bourgeois, Jr., D.D.S. 
and Gary G. Goodell, D.D.S., M.S., M.A., the article suggests that 
problems in some patients using bisphosphonates may be triggered by a 
dental procedure, such as a tooth extraction, or could occur spontaneously.

To prevent complications, the article suggests that those who take 
bisphosphonates seek counsel from their medical and dental providers 
before any elective dental procedures, and that any non-elective dental 
work – especially extractions, which, the article notes appear to 
“precipitate the majority of this condition” – be done before starting 
bisphosphonate therapy. When dental work is required after starting 
bisphosphonate therapy, patients, physicians and general dentists should 
consult with appropriate dental specialists, including endodontists, 
because non-surgical root canal treatment may be a safer alternative to 
extraction.

“Bisphosphonates are important drugs that help manage the side effects 
of cancer treatments, as well as bone loss in people who have 
osteoporosis,” says JOE Editor Kenneth M. Hargreaves, D.D.S., Ph.D.. 
“But, as this article indicates, both healthcare professionals and 
patients should be aware of the risks so together they can ensure 
optimal dental treatment.”

American Association of Endodontists
The American Association of Endodontists, headquartered in Chicago, 
represents more than 6,600 members worldwide, including approximately 95 
percent of all eligible endodontists in the United States. The 
Association, founded in 1943, is dedicated to excellence in the art and 
science of endodontics and to the highest standard of patient care. The 
Association inspires its members to pursue professional advancement and 
personal fulfillment through education, research, advocacy, leadership, 
communication and service. For more information, visit the AAE Web site 
at http://www.aae.org.

Complete article and abstract available to the media by contacting 
Krista Sabia or Craig Samuels at Edelman.
-- 
Kathrynne Holden, MS, RD < [log in to unmask] >
"Ask the Parkinson Dietitian"  http://www.parkinson.org/
"Eat well, stay well with Parkinson's disease"
"Parkinson's disease: Guidelines for Medical Nutrition Therapy"
http://www.nutritionucanlivewith.com/

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