Jeffrey Bland, PhDPresident of Big Bold Health | Human Health Thought Leader

FMU March 2010 clip #2 Bone Health

22 Sept 2010 · 2 min

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1:38

Short excerpt from a YouTube clip (FMU March 2010 clip #2 Bone Health) featuring a brief clinician discussion about bisphosphonate therapy. The speakers acknowledge that osteonecrosis of the jaw following tooth extraction is a real but uncommon adverse event, most reported with prolonged/high-dose use in cancer patients; it is unlikely common in postmenopausal osteoporosis. The speakers also note the risk has been exaggerated by dentists and that mechanisms (including possible endothelial effects and impaired socket healing) remain unclear.

Chapters

Okay, so let's go back to your bisphosphonate. There's been, at least from my reading, some concern about this effects on osteoclasts and mandibular necrosis. Is that a real clinical concern or is this just an artifact?
All right, so with prolonged bisphosphonate therapy and repeated therapy, particularly in patients with cancer who are given lots of bisphosphonates, often to suppress hypercalcemia of malignancy after prolonged therapy, there have been case reports of what's called osteonecrosis of the jaw, which generally follows a tooth extraction. Is it real? Yes. Is it related to the bisphosphonates? Probably. Is it common? No. Is it common in the post menopausal osteoporosis? No. Has it been exaggerated by the dentist? Yes. Is it causing problems for patients and doctors? Yes, it is. It is a real event, but it's very uncommon and it is doing more harm than good with this broad advertisement or discussions that are really disproportionate to the problem and so that the mechanisms are not understood. They could be effects of bisphosphonates actually on the endothelium in the mouth and altered healing within the socket of the tooth.