Bisphosphonates, a class of drugs used to prevent broken and deteriorating bones in cancer and osteoporosis patients, have been linked to a serious side effect called osteonecrosis, in which areas of bone in the jaw die.
However, while small, but increasing, numbers of complaints seem to be popping up, along with rising numbers of lawsuits aimed at the drugs' makers, many unanswered questions remain.
One major question is just how many people are suffering from osteonecrosis of the jaw related to bisphosphonates. There are two varieties of the drugs, one taken intravenously by cancer patients (Zometa and Aredia), the other taken in lower-dose pill form by those with osteoporosis (Fosamax, Actonel and Boniva).
Incidence of osteonecrosis among cancer patients is estimated at between 1 percent and 10 percent, while incidence among osteoporosis patients is unknown.
Doctors and Dentists Puzzled
Patients want to know whether they should stop taking the drugs, and whether osteonecrosis is treatable, but doctors and dentists don't have the answers. There is virtually no firm data available, and studies to provide answers are just beginning.
Invasive dental procedures, such as tooth extractions, may spur osteonecrosis, so some dentists have stopped treating patients taking the drugs. As for treatments, the best solution seems to be antibiotic rinses, but many people with the condition have not gotten better.
All bisphosphonate drug labels must include the link to osteonecrosis of the jaw. However, the drugs remain in bones for years, so no one knows how long the risk of osteonecrosis remains, even if the drug is no longer being taken.