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Dentists advise of Oral Health Risk Associated with Osteoporosis and Cancer Drugs.
Monday, 17th December, 2007: The Irish Dental Association today advised patients being treated with Bisphosphonate drugs of a potential serious complication, associated with their use.
Many patients in Ireland are treated with Bisphosphonates for a broad variety of medical conditions including osteoporosis, multiple myeloma, bone metastasis in cancer, hypercalcaemia associated with cancer and Pagets Disease of bone.
The condition which may develop as a result of Bisphosphonate drug use is known as Bisphosphonate Related Osteonecrosis of the Jaw (BRONJ). BRONJ presents with areas of exposed and non healing bone in the jaw. It is a painful and debilitating condition with no specific curative treatment available at present. Therefore, dentists are advising that prevention of the condition is vitally important.
Bisphosphonates provide significant benefits for patients. However, dentists advise that BRONJ may develop spontaneously or can be linked to surgical procedures carried out on the jaws including tooth extraction, periodontal surgery or implant placement.
Mr Gerard Kearns, Consultant Oral and Maxillofacial Surgeon and Dr Okay Specialist Registrar in Oral Surgery at the Mid Western Regional Hospital together with their colleagues in the Departments of Geriatric Medicine, Haematology and Oncology have reviewed 79 patients treated with Bisphosphonates at the hospital.
Results from the ongoing study to date show 52 patients were treated with oral Bisphosphonates for osteoporosis and 27 were treated with intravenous Bisphosphonates for metastatic bone disease or multiple myeloma. No patients on oral Bisphosphonates in the study developed BRONJ. However, 18% (5 out of 27) of patients treated with intravenous Bisphosphonates developed BRONJ during a mean 2 year period of treatment. 4 of these patients developed the condition following tooth extraction and 1 patient had spontaneous BRONJ.
The clinical presentation of BRONJ has been more commonly associated with the potent intravenous medications of Bisphosphonates such as Zolendronate and Pamidronate used in the treatment of patients with bone related metastatic cancer. However, in studies in North America the condition has also been reported in patients being treated with less potent oral forms of the medication, such as Risedronate and Alendronate, used in the treatment of osteoporosis.
Mr Gerard Kearns said reatment of BRONJ is symptomatic with emphasis on oral hygiene, mouth rinsing and the use of antibiotics in the presence of infection. It has proven difficult to completely cure this condition and efforts must be directed towards prevention of BRONJ in patients at risk. It is strongly recommended that all patients should have a complete dental examination and any necessary treatment carried out prior to commencement of Bisphosphonate therapy.
For further information contact:
Stephen McNamara
MRPA KINMAN Communications
Tel 353 1 703 8603 / 087 917 6941
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