The below points were provided by Tim O’Brien of Levin Papantonio Thomas Mitchell Echsner & Proctor, P.A.:
- Fosamax falls within a class of drugs known as biphosphonates.
- Bisphosphonates are used in chemotherapy for metastatic cancers, including breast and bone. Other drugs within this class such as Aredia and Zometa are also used as chemotherapy and adjunct chemotherapy but are not indicated for use in non-cancerous conditions such as osteoporosis.
- Merck successfully sought and received from the FDA approval to market this drug for non-cancerous conditions such as osteoporosis and as a prophylactic treatment for post-menopausal women.
- Bisphosphonates are effective in the prevention of bone resorption, and thus inhibit bone density loss. However, bone resorption plays a critical roles in maintaining normal bone homeostasis, in fighting infection, and in the healing process. It is through this likely mechanism that jaw problems can begin from such small dental procedures as fillings, root canals, etc. Additionally, bisphosphonates inhibit endothelial cell function. Bisphosphonates also inhibit vascularization of the affected area. Bisphosphonates also induce ischemic changes specific to the patients mandibles (lower jaws) and maxillae (upper jaws) and these ischemic changes appear to be cumulative in nature.
- These factors combine to create a compromised vascular supply in the affected area. As a result, a minor injury or disease can turn into a non-healing wound. That in turn can progress to widespread necrosis (bone death) and osteomyelitis (inflammation of bone marrow).
- A recent medical article reveals that as many as 38% of patients on bisphosphonates therapy have necrosis of the maxilla.
- Dentists are now being advised to refrain from using any invasive procedure (such as drilling a cavity) for any patient on Fosamax.
- Once the necrosis begins, it is very difficult to treat and is not reversible.