Medicines can have jaw-dropping consequences

By Dr. Paul Schoenbeck

While people live longer now than ever before, part of the ability to live longer is by the use of drugs medicinal ones, of course. In the December 2005 issue of the Journal of the American Dental Association, the entire issue addressed the recent discovery of the medicines called Fosamax, Aredia, and other drugs used in the prevention and treatment of osteoporosis and osteopenia (thin and weak bones) and the effect they can have on the jaws. It was discovered that people who have been taking these medicines were having some serious and debilitating consequences from even routine dental work. While the official study was small, the initial results were very concerning.Anyone taking a medication for osteoporosis or low bone density should have a conversation with their dentist and physician about their dental health, current and planned treatment, and the consequences of being on these medicines.Taking these medicines and having any dental work involving the gums and jaw could result in a nasty complication called osteonecrosis of the jaw, or ONJ. ONJ is a very difficult thing to manage and can result in a person losing part or most of the jaw. This is a complication that no one wants to have. Basically, ONJ occurs when your jawbone actually dies and can never get healthy again. This means it must be removed by an oral surgeon. After removing part of your jaw, life will never be the same. It is disfiguring and debilitating. And, it all relates to the medicines used to treat the bones in the rest of your body.How it happens is very sophisticated, but it has to do with the fact that our jawbones are constantly under a state of change and the medicines affect the jaws in a different way than the bones in the rest of your body. While not everyone is at risk for ONJ, those taking the medications need to be aware of the potential problems. Those at the highest risk are people who have had or are undergoing treatment for cancer. Others at risk are those in poor health or with other health problems such as diabetes.It is important to realize that these medications stay in your body for many years after taking them. For example, if you take 40 mg today, your body will retain 20 mg in your body 10 years from now. The bottom line is: Be informed and plan any major dental work before you start taking these medicines. Since everyone has a different history and varying needs, the best thing to do is to confer with your doctors and make decisions that are best for you.Dr. Paul Schoenbeck is with North Country Dental in Gorham. He recently lectured at the Yankee Dental Congress in Boston. He can be reached at (603) 466-5015. Web address is www.northcountrydental.com.