Because Fosamax is relatively new, experts say, the long term risk of ONJ is unknown. In addition, unreported cases of may be considerable, according to Diane Wysowski of the FDA's Office of Drug Safety, because doctors may attribute the pain caused by the condition to osteoporosis.
Dr Gregory Lutcavage, an oral and facial reconstructive surgeon, told Argus-News, there are three bisphosphonate drugs under scrutiny: Fosamax, Aredia, and Zometa.
In the early 1990s, he said, the intravenous version of the drug, Aredia and Zometa, were primarily used in treating bone cancer to prevent bone and spinal fractures. He says both drugs were excellent because they prolonged and improved the cancer patient's quality of life.
But Fosamax, taken orally, and for far less serious conditions, has become a different matter since dentists began noticing patients on Fosamax whose dental extractions would not heal properly.
This is not the first time problems have surfaced with this type of drugs, Dr Lutcavage advises. As far back as 1846, he says, there were reports of patients having jaw problems as the result of the cumulative effect of the drugs.
With oral versions of these medications being prescribed more frequently, Dr Lutcavage told Argus-News, this is just the tip of the iceberg. As time goes on, he anticipates more cases in younger patients.
"What scares me the most are the ones that are not cancer patients," he says. "Some of these patients are going to be in their mid-40s and on."
Complicating the issue further is the fact that the effects are not readily seen; they're cumulative, he warns. "(Patients) may be on these drugs for a long period of time; it may not show," he said.
The average time for the IV medications is 12.7 months, he says, but Fosamax is a little over three years.
For people on these drugs, Dr Lutcavage cautions against doing anything to remove teeth because of the adverse effects that could result. "We're looking at a loss of jaw," he said.
And while reconstruction is an option by installing a titanium plate instead of bone replacement, he told Argus-News, he fears the plates and screws will loosen up over time.
The treatment available is merely symptomatic. "We just try to get them comfortable again," he said. "It's going to get to the point where people will have to live with exposed bone because we don't have the treatment."
Dr Susan Ott, an osteoporosis expert at the University of Washington, told the LA Times on April 6, 2006, that the issue is especially worrisome because the number of women taking bisphosphonates is likely to increase because women are now reluctant to take estrogen for menopause. "These drugs are still relatively new and problems sometimes take years to show up," she said.
"We're not quite sure what we're dealing with over the long haul," she told the Times. "Side effects like this should make ordinary, healthy women think twice."
The Times set off a fire storm among internet bloggers when it published a letter from Dr David P Eisenman, Assistant professor at the David Geffen School of Medicine at UCLA, in response to the article that said in part: "Congratulations for unduly frightening hundreds of little old ladies."
A woman name Elizabeth responded with: "Now, if that isn't the most chauvinistic, demeaning, and condescending comment I've ever read, I don't know what is."
Dr Gregory Lutcavage, an oral and facial reconstructive surgeon, told Argus-News, there are three bisphosphonate drugs under scrutiny: Fosamax, Aredia, and Zometa.
In the early 1990s, he said, the intravenous version of the drug, Aredia and Zometa, were primarily used in treating bone cancer to prevent bone and spinal fractures. He says both drugs were excellent because they prolonged and improved the cancer patient's quality of life.
But Fosamax, taken orally, and for far less serious conditions, has become a different matter since dentists began noticing patients on Fosamax whose dental extractions would not heal properly.
With oral versions of these medications being prescribed more frequently, Dr Lutcavage told Argus-News, this is just the tip of the iceberg. As time goes on, he anticipates more cases in younger patients.
"What scares me the most are the ones that are not cancer patients," he says. "Some of these patients are going to be in their mid-40s and on."
Complicating the issue further is the fact that the effects are not readily seen; they're cumulative, he warns. "(Patients) may be on these drugs for a long period of time; it may not show," he said.
The average time for the IV medications is 12.7 months, he says, but Fosamax is a little over three years.
For people on these drugs, Dr Lutcavage cautions against doing anything to remove teeth because of the adverse effects that could result. "We're looking at a loss of jaw," he said.
And while reconstruction is an option by installing a titanium plate instead of bone replacement, he told Argus-News, he fears the plates and screws will loosen up over time.
The treatment available is merely symptomatic. "We just try to get them comfortable again," he said. "It's going to get to the point where people will have to live with exposed bone because we don't have the treatment."
Dr Susan Ott, an osteoporosis expert at the University of Washington, told the LA Times on April 6, 2006, that the issue is especially worrisome because the number of women taking bisphosphonates is likely to increase because women are now reluctant to take estrogen for menopause. "These drugs are still relatively new and problems sometimes take years to show up," she said.
"We're not quite sure what we're dealing with over the long haul," she told the Times. "Side effects like this should make ordinary, healthy women think twice."
The Times set off a fire storm among internet bloggers when it published a letter from Dr David P Eisenman, Assistant professor at the David Geffen School of Medicine at UCLA, in response to the article that said in part: "Congratulations for unduly frightening hundreds of little old ladies."
A woman name Elizabeth responded with: "Now, if that isn't the most chauvinistic, demeaning, and condescending comment I've ever read, I don't know what is."
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