Book of Life

Last month I wrote about osteonecrosis (ONJ) of the jaw or “dead jaw” and how it relates to use of the drugs listed above. To review: ONJ is a condition in which the bone tissue in the jaw fails to heal after minor trauma, such as a tooth extraction, causing the bone to be exposed. The exposure can eventually lead to infection and fracture and may require long-term antibiotic therapy and surgery to remove the dying bone tissue. Sometimes large sections of the upper or lower jaw have to be totally (resected) removed. 

If your physician is recommending either the oral and especially if the IV (intravenous) drug is recommended, consider doing the following first if you can delay taking the medications:

Remove all unsalvageable teeth. Perform any planned surgical procedures such as implants or bone trimming required for a denture or removable partial. Stabilize and improve your periodontal (gum/bone) situation. Treat all decay. And do whatever root canals may be needed.

If you are already taking the IV form, you are at much greater risk of developing ONJ. In this case you should try to avoid any dental surgical procedures if possible. Treat dental decay as needed. Teeth hopeless due to decay can have root canals done and then be cut off at the gum line to avoid extractions. Clean teeth above the gums. Splint (bond together) loose teeth.

If your physician approves, many believe that a “drug holiday” of several months can reduce the risk of ONJ in patients taking the oral form, but not in those taking the IV form. A serum (blood) morning fasting “CTX” test is used to measure bone turnover (new bone development). A level of 150 or higher is believed to be an indicator that oral surgery can be safely performed. This CTX marker is useless in cancer patients. Some believe that a level of 200 should be achieved and some believe the test is not of great value. It is generally thought that if you have taken the oral form for less than 3 years there is not a problem for any oral surgery to be performed.

You May Also Like

Acclaimed Chef Pushkar Marathe’s Stage Kitchen & Bar Signs Lease at Restaurant Row in Boca Raton

The 2023 James Beard Award nominee’s concept will occupy the last available space within the development.

4 Rivers Smokehouse Launches E-Commerce Site for BBQ Enthusiasts

The authentic Southern-style barbecue concept has a restaurant in Coral Springs.

The LOOP Welcomes Back Friday Night Sound Waves Concert Series 

The free outdoor concert is held every Friday night from April 12 to May 17.

American Heritage Schools Host Annual “K-9 Cause: An Evening of Art” Auction

Funds raised will benefit the Broward Sheriff Foundation’s Retired K-9 Relief Fund.

Other Posts

Food For Thought

You’re late for work and skip breakfast, so during the commute, you pick up a donut and cup of coffee and you’re on your way. This common quick-fix breakfast scenario can cause dental problems. The sugars in donuts have been identified as a contributing factor for cavities. When one compares the sugars found in plain

Part I

Osteonecrosis of the jaw (ONJ) or “dead jaw,” is a very serious type of bone disease that can be excruciatingly painful and disfiguring. ONJ is a condition in which the bone tissue in the jaw fails to heal after minor trauma such as a tooth extraction, causing the bone to be exposed. The exposure can

The Book of Life

There may come a time when you need to make a dental appointment for a root canal. Now, that phrase can sound awfully scary, especially if you’re someone who has never heard of a root canal before. Root canals are a very normal procedure for dentists or endodontists to perform. In fact, more than 15

The Book of Life

What if you were able to take the young teeth that your children naturally lose and save them so that when your child becomes an adult, they are able to use the cells from those young teeth to possibly help them fight things like cancer later in life?  The good news is that you actually