The Dallas Morning News has an article today about the apparent link between the bone disease osteonecrosis and drugs called bisphosphonates, such as the popular Fosamax.
The article states that dentists and doctors suggest that patients about to begin taking such drugs schedule any invasive dental work before starting the medication. An excerpt from the article:
For now, the best guidance physicians and dentists offer is prevention. Patients taking bisphosphonates should be keenly aware of oral hygiene and routine dental care. If someone is about to go on the drugs, dentists say, necessary invasive dental work should be done beforehand, if possible. The need for dental work should also be weighed against the risks of delaying therapy.
If invasive dental work is unavoidable for someone already on bisphonates, the advice is less clear. The drugs have a remarkable ability to huddle inside the bone for years, so they will persist long after a person stops taking the pills.
For that reason, Dr. John Kalmar says that patients may need to talk with their physicians about going off the drugs in the months before needed dental procedures. Dr. Kalmar, an expert in oral surgery and pathology at Ohio State University, was senior author of the Annals of Internal Medicine report summarizing facts about osteonecrosis.
“Data will tell you that the density of the bone stays the same for several months up to a year after stopping the drug,” Dr. Kalmar said.
No one knows whether a drug holiday would help reduce the risk of jaw osteonecrosis, but Dr. Kalmar says it seems unlikely to do harm. He would also like to see an investigation into the effects of pulsing the drugs – stopping and starting them at various intervals – rather than taking them continuously for years.
