Dental Exams Recommended Before Bisphosphonate Therapy

A recent study, presented at the International Academy of Oral Oncology, suggests that in order to prevent jawbone disease, myeloma patients should receive a dental examination before beginning bisphosphonate (BP) therapy.
The duration of BP therapy and the severity of myeloma are linked to the development of jaw bone disease, or osteonecrosis of the jaw (ONJ). ONJ occurs when there is a loss of blood supply to the jaw, causing the jawbone tissue to die.
BPs are a class of drugs that prevent bone from breaking down. They are commonly given to decrease bone pain and reduce development of bone disease associated with multiple myeloma. Intravenous BPs include Aredia (pamidronate) and Zometa (zolendronic acid). Oral BPs include Actonel (risedronate) and Fosamax (alendronate). The study found significantly lower risk of ONJ with the use of oral BPs compared with intravenous BP treatment.
A retroactive study conducted by Dr. Salino of Lyon, France looked at 45 patients, with an average age of 67, who developed ONJ after an invasive dental procedure. He said that “in about three-fourths of the patients, necrosis typically appears after an invasive dental procedure.”
The research recommends that cancer patients receive a full dental examination and have their dental problems resolved before they start BP treatment.
For more information about preventing ONJ, see the full press release from Doctor’s Guide.
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