Osteonecrosis of the Jaws: Should You be Worried?

Dentistry and oral health are admittedly full of big words  for common problems.  One word you may hear thrown around that sounds scary at times is osteonecrosis, particularly osteonecrosis of the jaw, or ONJ.

What exactly is osteonecrosis?  Is it something you should be worried about or something that should be discussed with your dental professional?

First, let’s breakdown the word itself.  Osteo means anything related to bone.  Necrosis means death, particularly when describing the state of tissues.  With ONJ, the jawbone begins to weaken and eventually starts to die.  However, let us take a step back.  What leads to osteonecrosis of the jaws?  How do you know you are suffering from ONJ and not another issue with similar symptoms?  The answer is not so simple and often leads to individuals eventually diagnosed with ONJ to suffer from other conditions first, which are treated to prevent further complications.

Transparent photo of human head highlighting the jaw.

Osteonecrosis of the jaws occurs when bone has been exposed for 8 weeks or more with no history of radiation treatment.

In order for ONJ to be officially diagnosed, bone must be exposed for 8 weeks or more. This may or may not be the result of having a tooth removed or a dental implant placed.  ONJ frequently occurs spontaneously.  The patients who are most at risk for ONJ are taking antiresorptive medications for osteoporosis usually or cancer treatment as well.  The 2 classifications of these medications are bisphosphonates, with the most commonly prescribed bisphosphonates being Fosamax and Reclast.  The other classification of medication are denosumabs.  The most common medication in this classification for osteoporosis is Prolia.  Disclosing all the medications that you are on to your dentist is extremely important to prevent osteonecrosis from occurring.  If you are on a bisphosphonate medication or a  denosumab medication for either osteoporosis or cancer, it may lead to a modification of your treatment plan.

Symptoms of ONJ can, but don’t always, include pain, and, while it is typically seen once the site has become infected, may include soft tissue swelling as well.  The good news is conservative treatment options are available if identified early by your dental professional.

If you or a loved one is having pain or swelling following a dental procedure, it is important to talk to your dental professional sooner rather than later, particularly if you need a tooth removed or are planning to have a dental implant placed.  Dr. Platt is an expert in oral pathology and will be able to quickly identify and treat issues involving osteonecrosis of the jaws or other pathologic conditions.  If you have concerns or need evaluation, please call our office at 219-864-1133.  Your mouth and your smile will thank you!

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