IN THE NEWS III

Beverly Vaughn, MD
Menopause and You Medical Coordinator

I'm taking medication for osteoporosis. Am I going to get osteonecrosis of my jaw?

This has been a frequent question that my patients have asked lately. Reports of osteonecrosis (a deterioration of bone in the jaw) have prompted enough concern that some women have stopped or declined to begin treatment with bisphosphonates for their osteopenia or osteoporosis. The most commonly used bisphosphonates are the oral medications Fosamax, Actonel, and Boniva. They have been proven to be beneficial in retarding bone loss. So, is there really a substantial risk for developing osteonecrosis?

In the November 30, 2006 issue of the New England Journal of Medicine, Dr. John Bilezikian provides very reassuring information. He explains that this condition occurs most frequently in patients that are using intravenous bisphophonate preparations and are cancer patients or patients who have suppressed immune systems, Patients in these categories who also have poor oral health may be at particular risk. Even in these situations osteonecrosis occurs infrequently.

Women who take the usual doses of the oral medications for osteoporosis prevention and treatment have a very low risk of jaw problems. Dr. Bilezikian notes that fewer than 50 cases have been reported. Given the risk of fracture in women with untreated osteoporosis is high and the likelihood of jaw disease so remote continuing treatment seems to be the wise choice.