Are Osteoporosis Drugs Killing Your Jaw?
16 Apr 2007
Several weeks ago I reported on a new revolutionary way to fight osteoporosis. This year astronauts will use it when they take to the space station the "Juvent Dynamic Motion Therapy Platform (DMT). It’s a non-drug method of preventing astronauts from developing brittle bones in a weightless atmosphere. I didn’t realize at the time it would also prevent osteonecrosis of the jaw which is now linked to current drugs for treatment of osteoporosis.
Today millions of patients are taking drugs (bisphosphonates) to prevent osteoporosis. But it’s ironic that bone drugs may cause harm to bones they’re supposed to protect. As I’ve told readers often, "You never get anything for nothing".
Reports of a possible link between the oral bisphosphonates (Fosamax, Actonel, Boniva) and also the intravenous ones ( Aredia, Zometa, Bonefos), and the death of bone tissue (osteonecrosis) began to appear in 2003. Dentists began to detect this problem following dental procedures.
But what put the issue on the map was a report by Dr. Salvatore Ruggiero in the Journal of Oral Surgery. Dr. Salvatore and his colleagues identified 63 patients with osteonecrosis of the jaw. Most of these were cancer patients who had been given biophosphonates intravenously. Six were taking the "bone savers" by mouth.
But what could cause jaw bones to rot? Most people look on bone as being inactive. But bone, like other tissues, is alive and constantly changing. Osteoclasts are continually chomping away at bone leaving open spaces, while osteoblasts are building up bone. It’s a never-ending process with more bone produced in early life and less later on.
The health of bone also depends on a normal blood supply. As we age, new blood vessels are being formed and others pruned away. And some researchers believe that these drugs decrease the growth of new blood vessels. It’s for this same reason they are used to treat cancer. They deny the malignancy the blood it needs to grow. But this effect is bad for bone that needs a healthy blood supply to keep growing.
Other researchers believe these drugs may have a two-pronged effect, that they cause an increase in bone strength in the short run, but may impair new bone formation in the long run. However, the jury is still out on the final cause of osteonecrosis.
The other conundrum is why osteonecrosis occurs only in the upper and lower jaws. Why not elsewhere? No one is sure, as jaw bone is consistently the same as other bone. One possible explanation is that these bones are exposed to considerable stress during eating. And infected teeth may also play a role.
Since millions of North Americans are taking "bone savers", what can be done to decrease the risk of developing osteonecrosis? In this case an ounce of prevention is worth a pound of cure. Once the problem occurs there’s no way to reverse the trend.
In the case of patients being treated for cancer, the risk of developing osteonecrosis must be balanced against the benefits of these drugs. But if dental surgery is needed it’s prudent to have this done prior to being treated with such medication.
Some doctors believe it may be wise to take a break from this therapy if you are scheduled for a dental procedure. But this may not make much difference as these drugs continue to exert their effect long after they’ve been taken.
So what is the message? Of course you must follow your doctor’s advice. But the ideal situation is not having to resort to such drugs. So build up bone naturally by taking adequate amounts of calcium, vitamin D, and keep bones healthy by exercising.
Placing stress on bones keeps bones strong. This is the basic principle of the DMT platform that transmits high frequency, low intensity mechanical forces through a person’s feet and up through the spine. These fast, gentle, accelerations trigger tiny stresses on bones which respond by growing stronger and increasing bone density.
Unfortunately the Juvent DMT platform costs $2,995. But it’s less expensive than long-term treatment with drugs. Besides, unlike drug therapy there are no known complications. For more information see the web site www.juvent.ca
