Bisphosphonates and Osteonecrosis in the Mouth

An example of bisphosphonate related osteonecrosis

Bisphosphonate Related osteonecrosis

Medications to help reduce the effects of osteoporosis have been a great help to the sufferers of the disease. Unfortunately, as there is with most medications, there are side effects. The main oral concern of these side effects is a malady called bisphosphonate-related osteonecrosis,BON, which is essentially localized bone death. After oral or periodontal (gum) surgery, wound healing can be compromised to the point that raw, denuded bone can be present and continues to be a nagging problem for the sufferer. It was a condition that was common in cancer patients who received radiation treatment. However, with the advent of the osteoporosis medications, this affliction became more common. The good news is that those receiving oral medications versus intravenous were significantly less likely to be affected by BON. The most popular of these medications go under the brand names of Fosamax, Uredic, Boniva and Zometa. If any type of oral surgical procedure is contemplated, the dentist must be made aware that the patient is taking a bisphosphonate drug.  Since there is no treatment available for BON, a decision must be made weighing the risk versus the benefits of doing the surgery.