Bisphosphonates

 Bisphosphonates are a class of medications intended to strengthen bone by preventing bone turnover and resorption.  They are typically prescribed by your physician for conditions involving weakening bone such as osteoporosis, metabolic bone diseases, and primary and metastatic cancers.  It includes medications, in order of increasing strength, such as Aredia, Nerixia, Fosamax, Boniva, Actonel, and Zometa.  While many of the oral bisphosphates are very safe, as with all medications, there are potential side effects and risks with bisphosphonates.  A prescription for these medications should involve a detailed discussion with the prescribing physician regarding these risks.
One of the potential risks, particularly with the stronger injectable or intravenous bisphosphonates, is what has been termed Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ), or Medication-Related Osteonecrosis of the Jaw (MRONJ).  In these circumstances, the inhibited bone turnover by the medications prevent the upper and/or lower jaw bones from properly healing from oral trauma, or from surgical procedures such as a dental extraction.  The exposed bone dies and has the potential to spread.  This can lead to painful and prolonged healing requiring long term antibiotics and possible surgery.
Prior to starting these medications it is important to have your dentist perform a thorough exam and optimize your oral health.  This may include control of tooth decay, replacement of failing restorations, and checking for proper fit of dentures.  If oral surgery is required, it should be performed prior to the start of these medications, or after having stopped the medications for some time (injectable or intravenous bisphosphonates).  Please consult with our experience oral surgeons at Heritage Oral Surgery regarding this and many other oral surgery needs, and please keep in mind that most patients taking the oral form of these medications are at minimal risk of complications and do not need to stop taking them for routine oral surgery.
Heritage Oral Surgery & Implant Centers is located at 27450 Tourney Road, suite 160 in Valencia.  For more information, please call 661-253-3500 and visit www.heritageoralsurgery.com.