ALLERGY, RESPIRATORY
Air Pollution May Raise Blood Pressure
Combating Myths About Seasonal Allergies
Overweight Moms More Likely to Have Asthmatic Kids
ALTERNATIVE MEDICINE
Licorice May Block Absorption of Organ Transplant Drug
Should Your Child Be Seeing a Chiropractor?
Grapefruit Compound Inhibits Hepatitis C Virus
ANIMAL CARE
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
Separation Anxiety, Canine-Style
Beware of Dog Bites
BONES & JOINTS
Improved Hip Implants Can Last 20 Years
Autumn Sees More Women With Bunion Problems
Vitamin C Protects Some Elderly Men From Bone Loss
CANCER
More Cancer Tests Mean More False-Positive Results
No Verdict Yet on Grape Seed Extract vs. Breast Cancer
Healthy Behaviors Slow Functional Decline After Cancer
CAREGIVING
Critically Ill Patients Lack Vitamin D
Birthmark or Blood Vessel Problem?
Timing May Matter in Organ Donation Decisions
CIRCULATORY SYSTEM
Support Network May Play Role in Benefits of Drinking
Exercise Extends Life of Kidney Patients
Salt Boosts Blood Pressure in High-Risk Patients
COSMETIC
Study Evaluates Laser Therapies for Hair Removal
With Psoriasis, the Internet May Offer Hope
Contact Lenses Boost Kids' Self-Image
DENTAL, ORAL
Acid Drinks Blamed for Increase in Tooth Erosion
Sports Drinks May Be Tough on Teeth
A Sweet Way to Shield Baby's Teeth
DIABETES
Findings Challenge Tight Glucose Control for Critically Ill Patients
Treatment for Type 2 Diabetes Updated
Fructose-Sweetened Drinks Up Metabolic Syndrome Risk
DIET, NUTRITION
Coffee Drinkers Might Live Longer
Iced Teas Pose High Risk of Kidney Stones
Probiotics Are The Good Guys
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Stomach Germ May Protect Against Asthma
Pesticides Linked to Parkinson's
Are Medical Meetings Environmentally Unfriendly?
EYE CARE, VISION
Nearly 18 Million Will Have Macular Degeneration by 2050
Cases of Age-Related Farsightedness to Soar
When Corks Fly, Watch the Eyes
FITNESS
After a Stroke, Light Exercise Gets Hands, Arms Working Again
Yoga Can Ease Lower Back Pain
FDA Mandates New Warnings for Botox
GASTROINTESTINAL PROBLEMS
HRT Use Raises Risk of Stomach Trouble
Bowel Prep Harder on Women Than Men
Gum Chewing May Speed Colon Surgery Recovery
GENERAL HEALTH
Diet, Exercise May Slow Kidney Disease Progression
Varicose Veins May Mask Larger Problem
Sleep and Do Better
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
HEALTH & TECHNOLOGY
The Internet Is Becoming One-Stop Shopping for Health Help
Save Your Aging Brain, Try Surfing The Web
Magnet Therapy May Ease Hard-to-Treat Depression
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Walk Long, Slow and Often to Help the Heart
Estrogen May Help Men's Hearts
Cherry-Enriched Diet Cut Heart Risks in Rats
INFECTIOUS DISEASE
Swine Flu Loves a Crowd
Hand Washing 10 Times a Day May Help Keep Flu Away
Poor Restroom Cleaning Causes Cruise-Ship Sickness
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Better Sleep, Grades Seem to Go Up
Decline of Underweight Children in U.S. Continue to Fall
Teens Lose More Weight Using Healthy Strategies
MEN'S HEALTH
Lots of Sex May Prevent Erectile Dysfunction
The Dark Side of Vegetarianism
Soy Linked to Low Sperm Count
MENTAL HEALTH
Memory Loss Help from Brain Supplement Prevagen
Love Hormone May Ease Discussion of Painful Topics
Have a Goal in Life? You Might Live Longer
PAIN
Acupuncture, Real or Fake, Eases Back Pain
Are We Exercising Pain Away? Not So Much.
'Cell Phone Elbow' -- A New Ill for the Wired Age
PHYSICAL THERAPY
PREGNANCY
Heart Defects in Newborns Linked to Antidepressants
Pre-Pregnancy Weight Linked to Babies' Heart Problems
Exercise Boosts Bone Density in Breast-Feeding Moms
SENIORS
Nighttime Urination Linked to Higher Death Rate Among Elderly
15-Point Test Gauges Alzheimer's Risk
A Little Alcohol May Stave Off Alzheimer's
SEXUAL HEALTH
SLEEP DISORDERS
Sleeping Could Help Women Lose The Baby Fat
Meditation May Help Put Primary Insomnia to Bed
Exercising Throat Muscles May Relieve Sleep Apnea
WOMEN'S HEALTH
Steady Weight Gain Boosts Late-Life Breast Cancer Risk
Acupuncture May Ease Depression During Pregnancy
Exercise Boosts Bone Density in Breast-Feeding Moms
Add your Article

Study Links Osteoporosis Drugs to Jaw Trouble

THURSDAY, Jan. 1 (HealthDay News) -- The proportion of people taking widely prescribed oral osteoporosis drugs who develop a nasty jaw condition may be much higher than previously thought, a new study suggests.

Previous reports had indicated that the risk of developing osteonecrosis of the jaw (ONJ) from bisphosphonates in pill form were "negligible," although there was a noted risk in people taking the higher-dose intravenous form of the drug.

But Dr. Parish Sedghizadeh, an assistant professor of clinical dentistry at the University of Southern California School of Dentistry in Los Angeles, said his clinic is seeing one to four new cases a week, compared to one a year in the past. This led him to investigate the phenomenon and publish the findings in the Jan. 1 issue of the Journal of the American Dental Association.

"This is more frequent than everybody would like to think it is," said Sedghizadeh, lead author of the study.

ONJ is characterized by pain, soft-tissue swelling, infection, loose teeth and exposed bone.

Dr. James Liu, chairman of obstetrics and gynecology at MacDonald Women's Hospital at Case Medical Center, University Hospitals in Cleveland, said the finding "does not mean that women should stop taking the drug if they're on it. It does mean that there may be more frequent side effects than was previously known."

Bisphosphonates are medications used to reduce the risk of bone fracture and to increase bone mass in people with osteoporosis. They're also used to slow bone "turnover" in people who have cancer that has spread to their bones, and in people who have the blood cancer multiple myeloma.

Use of bisphosphonates has been associated with other problems in the past, including an increased risk of atrial fibrillation (a type of abnormal heart rhythm), unusual fractures of the thigh bone, and inflammatory eye disease.

After searching the USC School of Dentistry's electronic medical records database, the study authors found that nine of 208 patients taking Fosamax had active ONJ, a prevalence of about 4 percent. All were patients who had undergone some kind of dental procedure, such as having a tooth removed.

Fosamax (alendronate) is the most widely prescribed oral bisphosphonate and has been the 21st most prescribed drug in the United States since 2006, according to background information in the study.

The jaw complication has been seen in patients taking Fosamax for as little as one year. It seems to occur most frequently after routine tooth extraction, the study authors said.

Although no one is sure why bisphosphonates seem to have this effect only on jaw bones, Sedghizadeh speculated that the drugs may make it easier for bacteria to adhere to bone that is exposed after a tooth extraction.

Previously, experts had thought that ONJ in people taking intravenous bisphosphonates was related to their underlying condition (for example, cancer) than to the actual drug, Liu explained.

The USC School of Dentistry now screens every patient for bisphosphonate use.

"As a school now, we don't have complications any more, we only have referrals," Sedghizadeh said. "We put patients on anti-microbial, anti-fungal rinse one week pre-operatively or post-operatively. If they have been on bisphosphonates six months or a year or longer, then we have a prevention protocol which has been very, very effective."

According to a statement released by Merck & Co., which makes Fosamax, the new study "has material methodological flaws and scientific limitations, making it unreliable as a source for valid scientific conclusions regarding the prevalence of ONJ in patients taking alendronate."

No reports of ONJ have been noted in controlled trials involving more than 17,000 patients, the statement said.
-Amanda Gardner

More information

To learn more about ONJ, visit the American Dental Association.



SOURCES: Parish Sedghizadeh, DDS, MS, assistant professor of clinical dentistry, University of Southern California School of Dentistry, Los Angeles; James Liu, M.D., chairman, department of obstetrics and gynecology, MacDonald Women's Hospital at Case Medical Center, University Hospitals, Cleveland; Merck & Co. statement; Jan. 1, 2009, Journal of the American Dental Association

Last Updated: Jan. 01, 2009

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