ALLERGY, RESPIRATORY
Air Quality Better in Northeast, Midwest
Climate Change Could Sting Allergy, Asthma Sufferers
Air Pollution May Raise Blood Pressure
ALTERNATIVE MEDICINE
Animals Respond to Acupuncture's Healing Touch
Pain-Relieving Powers of Acupuncture Unclear
Health Tip: Anticipating Acupuncture
ANIMAL CARE
Safe Toys for Dogs
'Comfort Dogs' Come to Emotional Rescue
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
BONES & JOINTS
Study Examines How Rheumatoid Arthritis Destroys Bone
Most Women With Osteoporosis Unaware of Raised Fracture Risk
Active Young Women Need Calcium, Vitamin D
CANCER
Strenuous Daily Workout May Keep Cancer at Bay
Researchers ID Genetic Markers for Esophageal Cancer
To Quit Smoking, Try Logging On
CAREGIVING
New Guidelines for Treating Heart Failure
Omega-3 Fatty Acid May Help 'Preemie' Girls' Brains
MRSA Infections Spreading to Kids in Community
CIRCULATORY SYSTEM
Salt Boosts Blood Pressure in High-Risk Patients
Bye, Bye Back Fat?
Walk 100 Steps a Minute for 'Moderate' Exercise
COSMETIC
Wrinkle Fillers Need Better Label Warnings: FDA Panel
Get Sugared!.... Its a sweet choice for hair removal
Science May Banish Bad Hair Days
DENTAL, ORAL
Hormones May Be to Blame for Women's Cavity Rates
A Sweet Way to Shield Baby's Teeth
Obesity Boosts Gum Disease Risk
DIABETES
Lifestyle Factors Tied to Older Adults' Diabetes Risk
Red-Grape Compound May Improve Diabetes
Out-of-Control Blood Sugar May Affect Memory
DIET, NUTRITION
Fatty Acid in Olive Oil Wards Off Hunger
Eating Vegan or Raw-Vegan at Regular Restaurants
Mediterranean Diet Plus Exercise Lowers Alzheimer's Risk
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
Clear Skies Have Become Less So Over Time, Data Show
Disinfectants Can Boost Bacteria's Resistance to Treatment
EYE CARE, VISION
Autistic Children Make Limited Eye Contact
Retinal Gene Is Linked to Childhood Blindness
Hybrid Cars Pose Risk to Blind, Visually Impaired
FITNESS
Yoga Can Ease Lower Back Pain
Be Healthy, Spend Less
Daily Exercise at School Yields Rewards
GASTROINTESTINAL PROBLEMS
Traditional Nonsurgical GERD Treatments Not Impressive
New Yogurt May Ease Stomach Ulcers
New Guidelines Issued for Management of IBS
GENERAL HEALTH
Biomarkers May Help Measure Rate of Decline in Dementia
Any Old Cane Won't Do
Soluble Fiber, But Not Bran, Soothes Irritable Bowel
HEAD & NECK
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
HEALTH & TECHNOLOGY
Save Your Aging Brain, Try Surfing The Web
Combating Myths About Seasonal Allergies
Using Light Therapy to Silence Harmful Brain Activity
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Quitting Smoking Doubles Survival in Early Stage Lung Cancer
Western Diet Linked To Heart Disease, Metabolic Syndrome
Review Confirms Links Between Diet, Heart Health
INFECTIOUS DISEASE
More Medicinal Uses for Pomegranate
Poor Restroom Cleaning Causes Cruise-Ship Sickness
Older Adults May Have Some Immunity to Swine Flu
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Most Depressed Teens Don't Get Treatment
Play Creatively as a Kid, Be a Healthier Adult
Music May Temper Pain in Preemies
MEN'S HEALTH
Eating Fast Until Full Triples Overweight Risk
Varicose Veins May Mask Larger Problem
Exercise May Prevent Prostate Cancer: Study Shows
MENTAL HEALTH
Massage Fosters Healing in Bereaved Relatives
The Unmedicated Mind
Bullying Seems to Affect Kids Years Later
PAIN
Alleviating Rheumatoid Arthritis
Acupuncture, Real or Fake, Eases Back Pain
'Cell Phone Elbow' -- A New Ill for the Wired Age
PHYSICAL THERAPY
PREGNANCY
Sugary Colas Tied to Gestational Diabetes
Acupuncture May Relieve Acid Indigestation In Pregnancy
Breast-Feeding Benefits Moms and Babies
SENIORS
Mediterranean Diet Plus Exercise Lowers Alzheimer's Risk
High-Impact Activity May Be Good for Old Bones
Boost In Elderly Population Will Be Felt Worldwide
SEXUAL HEALTH
SLEEP DISORDERS
Meditation May Help Put Primary Insomnia to Bed
Sleeping Could Help Women Lose The Baby Fat
Moderate Aerobics May Ease Insomnia Symptoms
WOMEN'S HEALTH
Exercise Boosts Bone Density in Breast-Feeding Moms
Natural Therapies for Menopause
Varicose Veins May Mask Larger Problem
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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