What are the side effects of Fosamax concerning the mouth?
Patients who are taking newer generation bisphosphonates like Fosamax hold increased chance of osteonecrosis in the jaw bones (both maxilla and mandible). While the severity of the disease is not really yet prearranged or what percent of patients are affected, if you have an infection in the dental area and are on the drugs, see your dentist right away.
I'm a dentist.
Fosamax is in a class of drug called bisphosphonates, used for various reasons--treating osteoporosis is one of them. It causes, if memory serves, increased bone mineralization and thus decrease vascular component. With any structure in the body, less blood supply means difficulty healing and increased risk of infection...especially surrounded by the presence of trauma and exposure of the bone to oral bacteria--such as that which occurs during tooth extraction.
Routine dental work, e.g. fillings, root canals, etc. are perfectly fine. Problems can arise when dental work involves trauma to the bone. Generally, you'll find that an extraction site fail to heal properly, continues to hurt, and may develop purulent drainage. This is osteonecrosis. It is very important to note that because the maxillary bone have a greater blood supply than the mandibular bone, osteonecrosis is less common in the maxilla than the mandible.
Treatment, unfortunately, is thoroughly difficult because it often requires MORE surgery to the bone, i.e. debridement of the infected bone and long periods of antibiotic therapy.
Fosamax, if memory serves, is one of the bisphosphonates that is least possible likely to cause this problem.
There have been reports of exposed dead bone in the jaws of pateints who are on a class of drugs call bisphosphonates. It is much more common in the intravenous (IV) form than the oral form (like fosamax) The IV drugs are given for cancers that have gone to the bone, and are given contained by pretty high doses.
Now fosamax is also a bisphosphnate, but is taken orally and in smaller doses. Millions of people are on these types of bisphosphonates and a virtuous many have had extractions without complications or any bone complications. In one study looking at two highest medical centers over a two year period, there were 7 people on oral bisphosphonates who developed osteonecrosis out of I'm guessing hundreds of thousands of those.
At this point the recommendations for the oral bisphosphonates regarding dental are not truly clear, but making sure you're taking good care of your teeth is other a good idea. If you're concerned, I'd talk to the physician who prescribed the fosamax and find out if it is beneficial enough to maintain a potential risk.
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