Osteoporosis drugs and serious jaw problems have been linked in past studies, but new research presented at the International Association for Dental Research in San Diego finds a low risk with oral osteoporosis drugs, known as bisphosphonates.
Echoing the findings of previous studies, the researchers did find a higher increase in risk for intravenous bisphosphonates, taken by a minority of those with osteoporosis.
"The risk of intravenous bisphosphonates [and jaw problems] is increased by sixfold compared to oral bisphosphonates," says researcher Peter Tawil, DDS, a resident in postdoctoral periodontics at the University of Pennsylvania School of Dental Health.
The study was funded partially by an unrestricted grant from the Alliance for Better Bone Health, supported by Warner Chillchott, Sanofi-Aventis, and Procter & Gamble. Sanofi and Warner Chillchott manufacture oral bisphosphonates.
Athanasios Zavras began receiving messages from distraught patients in 2005 after case reports linked oral osteoporosis meds to bone death in the jaw. A number of doctors and dentists advised women and men taking these drugs to postpone dental work, fearing that procedures such as tooth extractions would exacerbate the problem. That's when Zavras, an associate professor in the Harvard School of Dental Medicine, decided to take a closer look at the purported link.
After analyzing the medical claims of 714,217 people, Zavras, along with Vassiliki Cartsos at the Tufts University School of Dental Medicine and Shao Zhu of Ingenix - i3 Drug Safety (the company that provided medical claims data), have concluded that oral osteoporosis meds seem to reduce the risk of jaw degradation. Clinical studies are needed to replicate and clarify the results, which appear in the January issue of the Journal of the American Dental Association.
The drugs, which are called bisphosphonates, inhibit cells that break down bone tissue, and a growing number of Americans with osteoporosis or low bone mass ingest them orally to halt bone loss. In fact, they have been used for this purpose since 1977. Some cancer patients also rely on bisphosphonates to prevent bone fragility and metastasis, but these individuals typically receive potent intravenous versions of the drugs.
Osteoporosis patients who took oral bisphosphonates were slightly less likely to have adverse jaw outcomes than osteoporosis patients who were not taking the drugs. The protective association was statistically significant. A generally similar pattern emerged in the analysis of people with cancer. Those who had received oral bisphosphonates experienced protective associations or slightly increased risks that were not statistically significant. But receiving intravenous bisphosphonates significantly increased an individual's risk for adverse jaw outcomes in both cancer patients and those with osteoporosis.
