This is why bone specialists assembled a task force in July to investigate the link between Fosamax and osteonecrosis (rotting) of the jaw (also known as ONJ). Specifically, they want to know why osteonecrosis occurs in people taking Fosamax intravenously, how it occurs, and how to prevent and treat it.
Unfortunately, not a lot is known about the link between osteonecrosis of the jaw and Fosamax. The first case was reported in 2003. Since then, between 400 - 700 new cases of osteonecrosis have been reported. Why osteonecrosis occurs is unclear - although it generally appears after dental surgery or tooth extraction, in some cases it develops spontaneously.
Osteonecrosis of the jaw can be an incredibly painful problem. It often causes ulcers of the mouth and skin sores, infections, exposed bone, and disfigurement. In some cases it leads to a loss of function.
Included on the panel of specialists are experts in bone disease and dentistry. They were convened by the Bone and Mineral Research Society. Another group investigating the link between bisphosphonates and osteonecrosis is the American Association of Oral and Maxillofacial Surgeons.
There are some theories as to why osteonecrosis occurs in patients taking Fosamax. One theory is that bisphosphonates prevent the jaw from repairing itself after injury because of the suppression of chum.
Unfortunately, experts are not sure how to treat osteonecrosis once it has developed. One possibility is long-term antibiotics.
Fosamax is a type of drug known as a bisphosphonate. Bisphosphonates are regularly prescribed for patients suffering from osteoporosis. Cancer patients use drugs such as Fosamax to manage bone pain and control malignancies that have spread to the bones. In such cases, Fosamax is taken intravenously. It can also be taken orally to prevent painful fractures.
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Because Fosamax and bisphosphonates are relatively new drugs, it is not clear what the risks of long-term use are.
If you are taking bisphosphonates such as Fosamax, avoid having invasive dental work done if at all possible. Follow a careful oral hygienic plan. If you must have dental work, talk to your doctor. It is not yet clear whether ceasing to take the medication before dental procedures will prevent the development of osteonecrosis.
(Merck, the manufacturer of Fosamax, is currently involved in thousands of lawsuits involving its drug Vioxx which is no longer on the market. Vioxx was pulled after a study revealed that people taking the drug had an increased risk of heart attacks and strokes.)