I have taken Fosamax and Boniva for steroid induced osteo. I had oral surgery including tooth extraction, gum clean up. sinus lift and implant. I now have dead jaw and am in treatment for that. I stopped Boniva and start Forteo injections tomorrow. My message is that even tho I read articles like yours and listened to my rummy, oral surgeon and dentist and root canal person I got this. ccording to a Oral Surgeon professor at UCLA, Dr. Yahara this is rare but he has seem quite a few cases. Please do not tell people that dental work after Fosamax is ok. I have a diganosis of Fosamax induced osteocronosis (sp) of the jaw. Articles like yours do no public service.

Bumping this for some recent questions.
Desert Rover makes a good point and what a horrible story...but remember that the mortality rate 6 weeks AFTER hip fracture is 14%...so while there is the RARE risk of osteonecrosis and precautions do need to be taken, there are certainly many benefits
Dr O.

Not to be total doom and gloom but mortality rate at 1 year after hip fracture is 25%
yipes

Why is it that my oral SURGEON would NOT do surgery if I'd been on Fosamax for over a year??? (oral medication) He was afraid of the 'dead jaw.' He and my dentist both had gotten printouts from the American Dental Society and shown them to me.

My gastrologist told me never to take fosamax because of my acid reflux.

Dr. Orrange ~ I could NOT get a full dental checkup BECAUSE I was on Fosamax ~ that's what I was trying to say.

They wouldn't TOUCH me unless and UNTIL I signed a waiver saying I would keep them BLAMELESS should my jaw become 'DEAD.'

I'd only been on Fosamax for less than a year! So your saying that this is NOT AN ISSUE is misinforming. Try telling that to the American Dental Society. Respectfully, lee

Does taking Fosamax mean you can NEVER AGAIN have dental work? That's the impression I'm getting from reading these posts.

I have a bottom partial denture and it just broke. If it doesn't involve intrusive dental work, can I get that fixed while on Fosamax? I've been taking it for two years.

Myridia ~ No, it doesn't mean that. You'd have to be off the drug for about a year before any ORAL surgery could be done. As far as normal dental work, that depends on your dentist.

In Michigan where I live, the dentists are VERY reluctant to treat patients who have been on Fosamax and similar type drugs. Must be there have been a number of "dead jaw" incidents here.

Best of luck & God bless. Hugs, Lee

You mention multiple myeloma in your post, and because of this I have to put my thoughts here as well as ask a question. My mom passed away at the age of 51 from this illness. I watched her suffer for 4 years beforehand, so for me this was when I was 14 to 18 years old. It all started one evening when she fell and couldn't get up. Shortly before this, she was complaining about her left hip hurting but she thought she had bumped it on something. Both hips were fractured and she had those awful hip replacements put in - this was 1967. She didn't like the crutches, went to a walker, and finally had to use a cane the rest of her life because of a pronounced limp on her left side. There were so many stays in the hospital for her that I couldn't even count them. Once a month transfusions, etc., and never a complaint. She is so dearly missed. My question -- do you think the cause of her hips breaking was the multiple myeloma itself OR could osteoporosis played a factor in that? At the age of 55 now, I was diagnosed with osteoporosis 2 years ago and one of my mom's sister is beside herself over this. She's convinced my mother had it too.

I think what Dr. Orange was stating in her post was that there was cases of 'dead jaw' in people with multiple myeloma. That was all. I don't think there's any way of telling if your Mom had osteoporosis unless someone was able to see her test results, i.e. bone density, X-rays, etc. Of course there's always a possibility, since she had to have both hips replaced! But there are other reasons for that too.

Wish *I* could help. Hopefully, the Dr. will pop back in SOMETIME. God bless. Hugs, Lee

My mother had SEVERE ostioperosis and WAS on Fosamax DAILY with supplements. Now she has Ostiopena and is on Fosamax weekly.

She has had dental work without any issues. SHe is 78 now.

I have steroid induced Osteoporosis. I am taking Miacalcin. I don't know if it is helping or hurting. I was told it works.

Due to an Immune deficiency I was very ill and had 6 oral surgeries and 15 root cannals. I now have 8 natural teeth without caps on the bottom front.

2 of the surgeries were for a bone graft.

I am on IVG meaning IV gamaglobulin. I don't produce enough on my own like most people.

I can feel in my mouth that the left side of my mouth has more bone and it seems like a lot more bone. I am speaking of the palet.

WHAT IS DEAD JAW?

"Dead Jaw" or osteonecrosis, is where the bone in the jaw dies, and basically erodes away. It can be caused by the drugs used for Osteoporosis. That's why many dentists/oral surgeons will ask you if you're on any of these drugs. My oral surgeon made SURE I was off Fosamax for at LEAST a year and that I wasn't ON it for more than a year, before he'd do oral surgery on me. Plus I had to sign a waiver making him "guilt free" should I develop 'dead jaw.'

I choose NOT to take any of these meds now, as I prefer to keep my teeth. Many dentists are even squirrely about cleaning teeth if you're on this stuff!!! It's got everyone scared.

Sorry I was late jumping in
Most of you have NOTHING to worry about

1) The risks of Jaw Osteonecrosis ("dead bone" in the jaw) is almost exclusively limited to patients with cancer (solid tumors like breast cancer and hematologic malignancies like multiple myeloma) receiving INTRAVENOUS bisphophonates (Zometa, Pamidronate)

2) Official recommendations APPLY ONLY TO THOSE WITH CANCER RECEIVING INTRAVENOUS or IV bisphophonates
3) FOr those people here is the recommendation: "patients should be advised to avoid dental procedures while receiving intravenous bisphosphonates as well as to identify and rectify dental problems prior to treatment with these agents."

4) I, too, have had oral surgeons in the community of Los Angeles have me "clear" my patients who have been on oral agents (boniva or fosamax) which is irritating as there is very very limited concern here. This is an example of behavior changing because of the fear of lawsuits....plain and simple...its just a fear of lawsuits. No dentist or oral surgeon should refuse treatment if you are on an oral agent for osteoporosis....period

Dr O.

My wife has (so far) lost all but a dozen teeth due to bisphosphonates administered for bone damage to her leg and knee as a result of Waldenstrom's macroglobulinemia . One side of her jaw has totally fractured, but the other side remains intact, permitting some very gentle biting with the retained front teeth. There has been intermittent but significant soft tissue damage due to the loss of bone pieces. Her oral surgeon basically recommends doing nothing but administering regular antibiotics to control infection in the mouth. The rule is to do no further harm.

Here is the helpful part: I created/modified several dozen recipes over the past year that she can eat and actually enjoy without chewing - mostly she uses her tongue and the top of her mouth to 'chew.' You can see these recipes by visiting my journal at soft-food-guy.livejournal.com

I hope these are helpful!

David