My dentist suggested I contact this researcher before using Zometa
 

Here's an article on a dental research from University of So. Cal. (USC) whom my dentist wanted me to contact before using Zometa. The "half-life" issue does concern me. Any problems with some of you out there? Realistically, it seems that many of you have been just fine, and I'm going to write Dr. Sedghizadeh and ask him if the safety factor is reduced once infusions stop or if there is a lingering concern, which seems to be the focus of this article. I pasted this in case some of you didn't want to click on the link, but if you prefer a better format, the link is included here.

Vicki


http://www.usc.edu/hsc/dental/update...hNecrosis.html

http://www.usc.edu/hsc/dental/update...tical_Line.jpgEven short-term use of common oral osteoporosis drugs may leave the jaw vulnerable to devastating necrosis, according to a new USC School of Dentistry study appearing in the January 1 Journal of the American Dental Association (JADA).
“Oral Bisphosphonate Use and the Prevalence of Osteonecrosis of the Jaw: An Institutional Inquiry” is the first large institutional study in the U.S. to investigate the relationship between oral bisphosphonate use and jaw bone death, said principal investigator Parish Sedghizadeh, assistant professor of clinical dentistry with the USC School of Dentistry.
After controlling for referral bias and other patient health factors, nine of 208 School of Dentistry patients who take or have taken Fosamax for any length of time were diagnosed with osteonecrosis of the jaw (ONJ). The study’s results are in contrast to drug makers’ prior assertions that bisphosphonate-related ONJ risk is only noticeable with intravenous use of the drugs, not oral usage, Sedghizadeh said.
“We’ve been told that the risk with oral bisphosphonates is negligible, but four percent is not negligible,” he said.
Most doctors who have prescribed bisphosphonates have not told patients about any oral health risks associated with the use of the drugs, despite even short-term usage posing a risk due to the drug’s tenacious 10-year half-life in bone tissue. Lydia Macwilliams of Los Angeles said no one told her about the risk posed by her three years of Fosamax usage until she became a patient of Sedghizadeh at the School of Dentistry.
“I was surprised,” she said. “My doctor who prescribed the Fosamax didn’t tell me about any possible problems with my teeth.”
Macwilliams was especially at risk for complications because she was to have three teeth extracted. The infection is a biofilm bacterial process, meaning that the bacteria infecting the mouth and jaw tissues reside within a slimy matrix that protects the bacteria from many conventional antibiotic treatments, and bisphosphonate use may make the infection more aggressive in adhering to the jaw, Sedghizadeh said. The danger is especially pronounced with procedures that directly expose the jaw bone, such as tooth extractions and other oral surgery.
After her extractions, two of the three extraction sites had difficulty healing due to infection, Macwilliams said. Luckily, with treatment as well as the rigorous oral hygiene regimen that USC dentists developed especially for patients with a history of bisphosphonate usage, the remaining sites slowly but fully healed.
“It took about a year to heal,” she said, “but it’s doing just fine now.”
Sedghizadeh hopes to have other researchers confirm his findings and thus encourage more doctors and dentists to talk with patients about the oral health risks associated with the widely used drugs. The results confirm the suspicions of many in the oral health field, he said.
“Here at the School of Dentistry, we’re getting two or three new patients a week that have bisphosphonate-related ONJ,” he said, “and I know we’re not the only ones seeing it.”

Thanks Vicki, My Dr. at MD Anderson wants me to start taking Zometa x 3 with my herceptin. My local onc will see my bone scan and talk to me in three weeks and I will then start. I talked to my dentist and he explained to me about the slow healing issues after tooth extractions. He said oral surgens are getting these cases and learning how to deal with the issue. Also that I was in good dential health care and it was more or less an issue for people with poor dential health and if I had to have something done he would send me to someone who has experience dealing with it. So on the dential end not to look at Zometa as a problem and it would make my bones stronger.

Thanks for posting this issue I look forward to everyones input.

quote that was not included in all articles
 

Hi,

When this study was reported (USC and oral bisphosphonates), not all the articles included what was to me the most important statement to communicate to dentists and patients:

"As a school now, we don't have complications any more, we only have referrals," Sedghizadeh said. "We put patients on anti-microbial, anti-fungal rinse one week pre-operatively or post-operatively. If they have been on bisphosphonates six months or a year or longer, then we have a prevention protocol which has been very, very effective."



It sound like these are pretty simple precautions to take, and pretty effective ones, too.


The source of this quote was USNews and World report website but it was written up many places - I'm sure you could google and get more information. URL of the article from which the above quote came:


http://health.usnews.com/articles/he...w-trouble.html


Tinyurl: http://tinyurl.com/72d2yn

I have a copy of that full article (Oral bisphosphonate use and the prevalence of osteonecrosis of the jaw) right here before me. Actually the research concerns oral biphosphonate, not IV (Zometa).
I wanted to go online to JADA to download the entire article and post it, but was unable to.
Basically the abstract says that oral biphosphantes were considered extremely low risk for ONJ in the past, but according to the abstract, there may be more of a risk then what was assumed.
Vicki, if you would like a copy of this entire article, you can either go to: http://jada.ada.org, then to the Jan 2009 issue.
Or...you can PM my with your address or FAX number and I would be happy to send you a copy of the article.

Also, on the bottom of the article, it gives contact info for Dr. Sedghizadenh. (ofc address as well as email)


Maryanne

Thanks for the info. I am just starting an oral BPS since being diagnosed with osteoporosis (yet another chemo/rads side affect). I was told too that it was more risky taking IV BPS, but it seems oral can be just as bad.

- Anna