Millions of patients take bisphosphonate medications (Fosamax, Actonel) for treatment of osteoporosis with no adverse reactions. However, there have been reports from patients of bone loss in the jaw that were further confirmed by their dentists.
Osteonecrosis of the jaw (ONJ) is when the lower jaw bone, or at times the upper jaw, dies and becomes exposed, usually after a dental extraction. Wound healing postextraction fails to progress properly and infection can occur. The symptoms of ONJ are toothache, possible altered sensation, jaw pain, loose teeth, recurrent soft-tissue infection, and exposed bone. There's currently no treatment for ONJ.
Reports show that as many as 95% of patients who developed ONJ were taking intravenous bisphosphonate medications as part of a cancer regimen. There's also some concern that patients taking oral bisphosphonate medications have developed ONJ. As a result, some dentists are urging their patients who take bisphosphonate medications to discontinue the medication for at least 1 month pre- and postextraction or dental implant surgery. However, at this point there's no evidence to suggest that a drug holiday has a clinical impact on the incidence or severity of the condition.
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