News on Osteonecrosis of the Jaw from the ADA and NOF

If you are confused about osteonecrosis of the jaw, the American Dental Association (ADA) and the National Osteoporosis Foundation (NOF) published a brochure to help you determine fact from fiction. You can order this brochure here,   to help you to understand what issues you may face with this type of disorder.   This new brochure titled: Osteoporosis Medications and Your Dental Health, will help to answer your questions.

osteonecrosis pamphlet

To order this brochure, please contact the ADA at 1-800-947-4746 or visit Ask for item W418

Ten million Americans have osteoporosis, and a majority of those consider taking a class of drugs called bisphosphonates.   Bisphosphonates include Fosamax, Actonel, Boniva, and Reclast for the treatment of osteoporosis.   If you've considered one of these drugs you've undoubtedly read about bisphosphonate-associated osteonecrosis of the jaw (BON) and probably remain a bit confused about what it is; how it's treated; who's at risk; and is it treatable?

One thing we know for sure is that all those who take a bisphosphonate do not automatically get BON (bisphosphonate-associated osteonecrosis of the jaw).   In fact BON is rare but a serious disorder that needs to be treated properly.

Many cancer patients take this medication in intravenous form, at a higher rate of frequency and in a much larger dose.   Of the relatively small numbers of patients who get this disorder are those who took this drug intravenously.   There's also a small chance of acquiring this disorder through the oral dose regimen used for osteoporosis treatment.

Unfortunately the Internet is loaded with misinformation on this, which really scares people unnecessarily.   That does not mean that this disorder isn't real, it is, but the odds of getting it are truly small when you look at the numbers of individuals with osteoporosis, fractures, fracture-related death and then osteonecrosis of the jaw.

Osteoporosis is responsible for 2 million fractures a year, and bisphosphonate drugs reduce that number by 40 to 50 percent.   That 40 to 50 percent reduction in fractures accounts for 100,000 prevented hip fractures and a large number of prevented fracture-related deaths every year.

Osteonecrosis of the jaw is a disorder where the blood supply to a bone stops or decreases and can cause infection or bone death.   According to the American Dental Association: "The typical clinical presentation of BON (Bisphosphonate-associated osteonecrosis of the jaw) includes pain, soft-tissue swelling and infection, loosening of teeth, drainage, and exposed bone.   These symptoms may occur spontaneously, or more commonly, at the site of previous tooth extractions.   Patients may also present with feelings of numbness, heaviness and dysesthesias of the jaw.   However, BON may remain asymptomatic for weeks or months, and may only become evident after finding exposed bone in the jaw (March 2006)."

If you've had a tooth extraction, took bisphosphonates, and have exposed bone, your oral surgeon may diagnose BON if your condition persists for more than eight weeks, and you've never had radiation to the head or neck.   If this is the case please educate yourself, by reading  the new brochure, and find out from the ADA web site what steps should be taken next to treat and heal this disorder.

If you are considering taking a bisphosphonate and have periodontal disease, or are contemplating an extraction, speak with your dentist about starting a good cleaning regime.   Your dentist will also help to monitor your dental health while taking these medications.

Special Thanks to the ADA/NOF for publishing this information, and to the ADA for providing the brochure to our readers here at