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Osteonecrosis of the Jaw (ONJ)
Osteonecrosis of the Jaw or Dead Jaw
Dead Jaw, also known medically as osteonecrosis of the jaw, is a very serious bone disease in which the bones in the jaw suffer death due to infection and rotting. In the most serious cases, individuals may have to remove large sections of the jawbone tissue to stop the progress of the disease. This delicate surgical procedure can result in the individual being unable to chew solid food. An inability to work, tend to personal affairs, or interact with family in a normal manner contribute to severe emotional distress in individuals suffering from Dead Jaw
While researching the causes of Dead Jaw, researchers have found that medications called bisphosphonates, such as Fosamax, have the ability to inhibit the creation of new blood vessels in the jawbone. This inability to produce new blood vessels quickly compromises the natural healing process of the jaw bone tissue, resulting in wounds from minor damage staying open. If the bone cannot heal, the open wound can get infected, start to rot, and bone death could occur.
Common signs and symptoms of Dead Jaw include pain, swelling, numbness or a feeling of heaviness in the jaw, drainage, infection of the gums, poor healing of the gums, loosening of the teeth, and exposed bone. The early treatment of patients using Fosamax and other bisphosphonates is very important to save the jawbone after a diagnosis of Dead Jaw. Often, Dead Jaw shows no symptoms for many weeks or even months. Quite a few of the symptoms will only develop after trauma to the mouth has occurred. Cases that are untreated or go undiagnosed have resulted in the bone collapsing, severely disfiguring the sufferer. Bone death cannot be reversed and the damage caused by Dead Jaw cannot be repaired. Experts have estimated that dozens of cases of Dead Jaw will occur in the United States annually in patients taking bisphosphonates such as Fosamax.
A connection between the bisphosphonate medications, such as Fosamax, and Dead Jaw was found in 2004 by studying clinical trials. When the findings were released by the Journal of Oral and Maxillofacial Surgeons, the US Food and Drug Administration (FDA) and the drug manufacturer, Merck and Company Inc. issued a drug side effect warning to medical professionals and the general public about the risk of contracting Dead Jaw while on medications such as Fosamax. It has been estimated that over 2,000 patients taking bisphosphonates such as Fosamax have suffered jawbone decay and death due to Dead Jaw, some suffering from severe pain and debilitation and becoming bedridden.
The warning indicated that trials conducted prior to the approval of Fosamax for retail sale did not demonstrate an increased risk of Dead Jaw, although the FDA does admit that the longer-term effects of a drug sometimes will not appear until the drug has been released to the public. It was determined that a warning to the medical community and public was warranted, but the risk was not severe enough to require a recall of Fosamax.
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