Biophosphates are a class of medication often prescribed for patients who are diagnosed with osteoporosis, the loss of bone strength and density, and also those on chemotherapy. Popular biophosphate brand names include Avedia, Zometa or Fosamax. Before taking these medications, however, patients should understand the "side-effect risk" of developing osteonecrosis of the jaw.
Osteonecrosis is a condition that often results in permanent and painful destruction of bone in the jaw. Caused by a combination of poor blood supply and impaired bone healing, it is (thus far) resistant to treatment and has become a serious concern of dentists.
For patients with osteoporosis, biophosphates work by inhibiting osteoclasts, the bone cells that dissolve old bone so that the body can build new bone. By slowing down the bone-dissolving osteoclasts, new bone growth is more dense and resistant to fracture. For chemotherapy patients, biophosphates halt the spread of cancer to the bone.
For patients who are contemplating chemotherapy, it is imperative to have a complete dental evaluation before starting therapy. For osteoporosis patients, a dental check-up is advisable to evaluate the health of bones in the jaws. For patients who develop osteonecrosis, the loss of jaw bone can be aggravated by tooth extractions, oral surgery, deep scaling and even dentures rubbing against the jaw.
It is far more effective to prevent osteonecrosis than to try to treat it after bone loss has occurred. In some cases, the most effective treatment is to work with a physician to evaluate an appropriate level of biophosphates or alternatives to biophosophates. Dentists also can give patients who are on biophosphates special treatment. For example, root canals on a hopeless tooth may be preferred to extractions, because removing the tooth starts a cascade of jaw bone loss that is difficult to stop.
The latest thinking for patients currently on biophosphates for osteoporosis, is to take a one year "vacation" from taking the medication to allow the body to grow new osteoclasts.
Always let your dentist know if you are taking, or planning to start taking, biophosphates.
For more information on biophosphates and osteonecrosis of the jaw click here.