What is Medication-related osteonecrosis of the jaw (MRONJ)?
Medication-related osteonecrosis of the jaw (MRONJ) is an uncommon but serious complication that can do serious damage to the jawbone. It can often occur after dental treatment - like pulling a tooth or when treating severe gum disease. When it occurs, it affects some people who are taking or have previously taken medications to fortify their bones. These medications, often referred to as bisphosphonates, may be used at higher doses to aid in bone cancer treatment or other types of cancer that have subsequently spread to the bone. These medications can also be prescribed to people who have delicate bones. More frequently, however, lower doses are often used to manage osteoporosis - a much more common diagnosis. Once a person has taken these medications the healing from a dental procedure may be reduced.
MRONJ is much more common when these medications are taken at higher levels, and as a result they may keep the jaw from healing properly after certain dental procedures that manipulate the bone. MRONJ is often seen with higher doses of meds and when one or more teeth are extracted. When MRONJ occurs it causes bone loss, pain, infection, tooth loss, and bone exposure.
RISK FACTORS
It is estimated that 10 of 100 people with cancer and who have received these medications develop MRONJ. Also, for those taking these medications for osteoporosis the number drops to 1 in 10,000.
Some other factors that increase the risk of developing MRONJ include:
over the age of 65 years
gum disease
tobacco use
poor fitting dentures
Diabetes
SYMPTOMS OF MRONJ
pain, inflammation, or gum or jaw infection
teeth that are loose
a feeling of numbness or a sensation of a heavy jaw
loss of the tissue covering bone or gums that never heal
UNDERSTANDING THE RISK OF DEVELOPING MRONJ
When a loved one is facing cancer, seeing their dentist might not seem so important. However, a thorough dental examination can help identify disease that can and should be treated before they start taking medications for bone strength - like bisphosphonates. Giving their dentist a completed health history which includes a comprehensive list of their past, present and future medications is very important.
If you or a loved one is being treated for osteoporosis, consider all the risks involved and speak with your physician. The small risk of developing MRONJ from osteoporosis meds is probably less than that of breaking a bone due to osteoporosis.
In addition to visiting with your dentist, improved dental care at home is important:
Brush twice daily with fluoride
Floss daily or use a water flosser
Choose healthy foods that are low in sugar
CONCLUSION
MRONJ is serious condition that affects the jawbone. It can occur after dental treatments that manipulate the bone after that person has been taking medications to strengthen their bones. Keeping up with your daily dental care at home and maintaining your regular visits to your dentist can help limit the need to undergo treatments with increased risk of developing MRONJ.
