Hi You answered my question asking about the osteonecrosis of the jaw and Fosamax, I wanted to get back to you. I have been taking it but I am always getting worried. Some topics make it seem doom and gloom, my doctors say it is a rare problem, but I have stopped for a few months a while back then went back on it, and am now debating again. I don't take anything else, I hate to take these unnecessary drugs. My husband is on high cholesterol and blood pressure and I am always telling him to change his diet instead of reaching for the drugs. So after reading again and noone telling me they are using the Fosamax I am again rethinking taking it. I wish I could find out statistically how many people are taking it. I did not use hormones when that was the big thing so don't know if I should stay with this. I hope you see this. Thank you dmh, I had osteopenia, and now with several years with the Fosamax I am "normal" or where I should be, but once you stop the Fosamax it reverts back. I did start with gum problems and had the gum surgery, and now go to dentist or periodontist every 3 months, alternating. So I am on top of things, I did have a root canal and then an Apicoectomy, rootcanal surgery up through the gum over the already root canalled tooth. And they said I might eventually loose that tooth anyway. I do have a slight pain in another tooth and I fear it will need to be eventually root canalled, so I worry I will need this tooth worked on , hopefully it is just a cavity.So I do worry it is the start of some disaster. Thank you so much for your answer you have eased some of my fears!! I am not the person you aimed the question at but i hope i can help:
I work at a clinic for a rheumatologist doing bone density testing and osteoporosis research. I have been here for 6 years and helped treat thousands of women and men with osteoporosis.
If you have osteoporosis as diagnosed from a bone density exam, I would take the Fosamax. The incidence of ONJ (osteonecrosis of the jaw) really is extremely low. It mainly occurs in cancer patients taking very high doses of bisphosphonates such as Fosamax, along with their other drugs. These cases are usually i.v. drugs, and as i stated, at much higher doses than Fosamax for osteoporosis.
The risk of developing ONJ is between 1 in 10,000 and 1 in 100,000. To prevent problems consider the following: visit your dentist regularly to maintain good oral health. Report any problems such as pain, swelling, gum problems, etc. If you need invasive dental work, stop taking the Fosamax temporarily.
Keep in mind that if you do have osteoporosis, you are at a much greater statistical risk of breaking a bone than of getting ONJ. And fractures can lead to morbidity. If you have osteoporosis, a medication to treat it is NOT unneccesary!
I have seen many bad cases of osteoporosis that have caused HUGE health problems, and lead to death. I have yet to see a single case of ONJ in this osteoporosis-based clinic.
Good luck.
Update:
there are other medications you can take, but most of them are in the same bisphosphonate family and carry the same risk level, including pamidronate. You could try Forteo, but it is really expensive and is more for severe OP.
If your bone density gets to a point where it is a normal level again, you will not need to take fosamax forever. After menopause is more than 5 years ago, there are other reasons that could cause accelerated bone loss that could be looked into including a parathyroid problem. But generally speaking, op medication is not meant to be taken forever and you should be able to have a low risk of an osteoporotic fracture at some point after taking the medication (WITH calcium and vitamin D) for awhile.
I would just quit taking it whenever you have dental work done. There are other medicines besides Fosamax that you can take. Boniva, pamidronate, reclast,zometa are just some of them. Ask your doctor about them or look them up online. |
