Patients with cancer or osteoporosis who are about to be treated with bisphosphonate drugs have been urged to have a dental check-up before proceeding with the treatment.
The advice has been issued because once on the treatment, which is very beneficial in preventing the development of secondary bone cancers and in the treatment of osteoporosis, a patient who needs a tooth extracted could discover their wound doesn't heal properly.
The condition which may develop is known as Bisphosphonate Related Osteonecrosis of the Jaw, or Bronj, and presents with areas of exposed and non-healing bone in the jaw. It is a painful and debilitating condition with no specific curative treatment available at present.
Some 79 patients who were treated with bisphosphonates were reviewed at the Mid Western Regional Hospital in Limerick recently and it was found that five patients who had received the drug intravenously had developed Bronj.
Four of these patients developed the condition following tooth extraction and one patient developed spontaneous Bronj.
Some 52 of the 79 patients reviewed were treated with oral bisphosphonates for osteoporosis and 27 were treated with intravenous bisphosphonates for metastatic bone disease or multiple myeloma.
Dr Gerard Kearns, consultant oral and maxillofacial surgeon at the Mid Western Regional Hospital, said it was important patients saw their dentist or GP for advice before starting treatment on the bisphosphonates.
Asked if the drugs should be removed from the market, he said they were widely used and their benefits outweighed their risk "at the present state of knowledge".
But he said patients to whom it had been suggested should start on these drugs should see their dentist first. The Irish Dental Association has also issued similar advice.
The common bisphosphonate drugs used in the Republic for osteoporosis include fosamex and actonel and for cancer include zometa and aredia.