Dental work and Boniva

Crazylady is right. Make
Crazylady is right. Make sure your dentist knows AND takes it seriously. Like many se's, they may be rare but they are happening to someone and it could just as likely be one of us. Osteonecrosis of the Jaw is difficult to treat and there are precautions he can take prior to doing the work. Some feel it is only the intravenous bisphosphonates that cause the problem but those in oral forms can as well although perhaps not as frequently. Apparently having BC increases our risk.

This is a tidbit of info I found on medline:

Osteonecrosis of the jaw in patients receiving intravenous or oral bisphosphonates.King AE, Umland EM.
Department of Pharmacy, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

To identify potential risk factors for the development of osteonecrosis of the jaw (ONJ) in patients receiving bisphosphonates, we conducted a MEDLINE search. We identified 44 English-language published case reports and case series describing 481 patients with bisphosphonate-related ONJ.

Our review of these reports indicated that ONJ occurs more frequently in patients receiving intravenous bisphosphonates (453 patients [94.2%]) than in patients receiving oral bisphosphonates (28 patients [5.8%]). Most patients who developed ONJ had cancer (451 patients [93.8%]), with multiple myeloma being the most common diagnosis, followed by breast, prostate, and lung cancers.

Nearly one third of patients had a history of glucocorticoid use. The inciting event (reported in 449 patients) preceding the diagnosis of ONJ was a tooth extraction or other surgical or invasive dental procedure in 309 patients (68.8%), whereas 93 patients (20.7%) developed ONJ spontaneously.

Guidelines for the prevention and treatment of bisphosphonate-associated ONJ have been developed but are largely based on anecdotal evidence. Patients receiving bisphosphonates must be counseled on the risks and benefits of therapy. Further studies will help to elucidate the pathophysiology, frequency, and risk factors for development of bisphosphonate-associated ONJ.

phoenixrising said:

Crazylady is right. Make
Crazylady is right. Make sure your dentist knows AND takes it seriously. Like many se's, they may be rare but they are happening to someone and it could just as likely be one of us. Osteonecrosis of the Jaw is difficult to treat and there are precautions he can take prior to doing the work. Some feel it is only the intravenous bisphosphonates that cause the problem but those in oral forms can as well although perhaps not as frequently. Apparently having BC increases our risk.

This is a tidbit of info I found on medline:

Osteonecrosis of the jaw in patients receiving intravenous or oral bisphosphonates.King AE, Umland EM.
Department of Pharmacy, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

To identify potential risk factors for the development of osteonecrosis of the jaw (ONJ) in patients receiving bisphosphonates, we conducted a MEDLINE search. We identified 44 English-language published case reports and case series describing 481 patients with bisphosphonate-related ONJ.

Our review of these reports indicated that ONJ occurs more frequently in patients receiving intravenous bisphosphonates (453 patients [94.2%]) than in patients receiving oral bisphosphonates (28 patients [5.8%]). Most patients who developed ONJ had cancer (451 patients [93.8%]), with multiple myeloma being the most common diagnosis, followed by breast, prostate, and lung cancers.

Nearly one third of patients had a history of glucocorticoid use. The inciting event (reported in 449 patients) preceding the diagnosis of ONJ was a tooth extraction or other surgical or invasive dental procedure in 309 patients (68.8%), whereas 93 patients (20.7%) developed ONJ spontaneously.

Guidelines for the prevention and treatment of bisphosphonate-associated ONJ have been developed but are largely based on anecdotal evidence. Patients receiving bisphosphonates must be counseled on the risks and benefits of therapy. Further studies will help to elucidate the pathophysiology, frequency, and risk factors for development of bisphosphonate-associated ONJ.

bisphosphonates reduce recurrence
Thanks phoenixirising, I could not remember osteonecrosis.

My onc told me and my husband yesterday that the research is showing more evidence that bisphosphonates reduce the chance of local recurrence. He again reassured my husband that the benefits of the Zometa (IV every 6 months) will out weigh the risks especially with close dental monitering.

The other issue that I am facing is that I have moderate-severe osteoarthritis in my knees and prior to the cancer my doc said I would probably be looking at knee replacement surgery within the next few years. The Zometa may help with the arthritis but it also makes me unable to have the joint replacement. But I prefer arthritis pain over recurrence.