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Some Drugs Cause Jawbone Problems

The following is a transcript of a report by medical editor Marilyn Brooks that first aired Sept. 6, 2006, on WTAE Channel 4 Action News at 5 p.m. The report re-aired Dec. 26, 2006.


An important warning for those of you who take medication to prevent osteoporosis: It turns out some of the drugs taken to prevent bone loss can actually cause deterioration of another kind.

The drugs in question are called bisphosphonates. They're widely used to prevent thin bones, but they cause osteonecrosis or dead bone and hundreds of lawsuits against the companies that make the drugs are being filed. The drugs under fire include fosamax, actimel and boniva.

For Marjorie Malush, the dentist office is all too familiar, but she's hoping for a solution to a painful problem.

"I will never be able to eat a hamburger," said Malush. "I will never be able to eat a frankfurter. I will never eat corn on the cob -- things that I thoroughly enjoyed eating."

Malush's excruciating jaw pain began in May after her family dentist pulled two teeth. A panoramic x-ray solved part of the mystery.

"He found a hairline crack in my jawbone," said Malush.

What happened to Malush is happening to thousands of women on medications to prevent bone loss including fosamax, actimel, and boniva. They build-up bone but cause a troubling side effect.

"The drug has prevented the body's natural ability to remove that bone, so that bone stays and as a result, it has no blood supply and because no blood supply, the bone is dead," said Dr. Joseph Cillo. "It causes secondary infection. It causes the pains and the other problems that come along with that."

Those other problems: exposed jawbone, which makes infection impossible to cure.

If you're wondering why the exposed bone is showing up only in the jaw, there's a good reason. The bone here is thinner than anyplace else in the body. It just so happens that the drug is absorbed more here than anyplace else in the body.

Spontaneous jaw fractures can happen, but usually it's an extraction or implant. There's no conventional treatment.

You can't go in and take this bone out, because it will make the problem worse.

Patients need life-long penicillin and anti-microbial mouth rinses. Malush may also need a metal plate. She is not a happy camper.

Women trying to prevent osteoporosis aren't the only ones facing lost jawbone. Bone cancer patients using intravenous aredia and zometa also have the problem. Those drugs are also bisphosphonates.

Experts suggest any man or woman on fosamax, actimel, or boniva for three or more years should get to an oral surgeon for a thorough examination of the jaw, before you have any extractions or implant work.

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