Osteonecrosis or “dead jaw” has been linked to patients using both injectable and oral bisphosphonates such as Fosamax, a review from FDA’s Office of Drug Safety states.

Fosamax is the brand name for the drug Alendronate. It belongs to a class of drugs know as bisphosphonates and is approved by the FDA for the treatment of Osteoporosis, or thinning of the bones. Bisphosphonate drugs have been used since 1995 to strengthen bone in women who are losing bone density. The have also been used for nearly 15 years in men and women who have cancer. Other bisphosphonates include Actonel, Boniva, Bonefos, Didronel, Aredia, Skelid and Zometa.

A connection between bisphosphonates such as Fosamax, and Osteonecrosis of the jaw (ONJ) was discovered in 2004. The findings were published in the Journal of Oral and Maxillofacial Surgeons and showed the side effects of Fosamax may include ONJ, a condition commonly called “dead jaw.”

Osteonecrosis of the jaw is a disease in which bone tissue in the jaw does not heal after minor traumas. Dental extractions that cause bone to become exposed can lead to fractures and infections often requiring long-term antibiotic therapy and surgery to remove the dead and dying bone tissue. Some researchers and pharmaceutical experts state that prevention and early treatment of patient using Fosamax is critical in the preservation of a healthy jaw bone. Individuals using Fosamax and other bisphosphonates should try to avoid tooth extractions and other major dental work while taking these medications.

Symptoms of “dead jaw” include irregular sore with exposed bone, pain or swelling in the infected jaw, infection, possibly with pus, altered sensation - numbness or a heavy sensation.

The highest risk factors for ONJ are:

1) taking bisphosphonates like Fosamax, especially in IV form

2) concurrent use of steroids

3) previous history of cancer, osteoporosis or Paget's disease

4) traumatic dental procedure, such as tooth extraction or dental implants.