Understanding Forteo and Its Link to Osteonecrosis of the Jaw
Osteonecrosis of the jaw (ONJ) is a rare but serious condition that has been associated with some osteoporosis medications like Forteo. ONJ causes parts of the jawbone to lose blood supply and die. This can lead to significant pain, infection, and disruption of normal jaw functions like chewing.
Forteo (teriparatide) is an injectable osteoporosis drug that helps build new bone density. It has proven effective for treating osteoporosis, especially in postmenopausal women with a high risk of fracture. However, Forteo has been linked to ONJ in a small number of cases.
What is the Connection Between Forteo and ONJ?
Researchers are still studying the relationship between Forteo and ONJ. It appears that the increased bone remodeling and growth stimulated by Forteo may also increase the risk of death of jawbone tissue in some individuals.
However, the overall risk seems to be low. Estimates suggest ONJ occurs in about 1 to 2 out of every 1,000 patients taking Forteo. And a study found that when ONJ did occur in Forteo users, 94% of cases were mild to moderate.
Who is Most at Risk of Developing ONJ While Taking Forteo?
Certain factors can increase an individual’s risk of developing ONJ when using Forteo:
- History of dental disease, dental surgery, or poor oral health
- Smoking
- Chemotherapy
- Corticosteroids use
- Diabetes
- Osteoporosis drugs used for over 3 years
Maintaining good oral hygiene and avoiding invasive dental procedures appears to reduce the chances of getting ONJ with Forteo.
Should I Stop Taking Forteo Because of ONJ Risk?
Discontinuing an effective osteoporosis treatment like Forteo is a complex decision that should be made carefully with your healthcare provider. There are a few key considerations when weighing the ONJ risk against benefits:
1. Severity of Your Osteoporosis
If you have advanced osteoporosis and a history of broken bones or height loss, the protective benefits of Forteo therapy likely outweigh the minimal chance of developing ONJ.
But if you have milder, early-stage osteoporosis you may want to explore less risky treatment options before considering Forteo.
2. Your Personal Risk Factors for ONJ
Those with poor dental health, dental disease, or certain medical conditions may want to avoid using Forteo for long periods due to heightened ONJ risk.
Talk to both your doctor and dentist about your individual risk profile.
3. Duration of Forteo Therapy
The chances of developing ONJ appear to increase the longer you take Forteo, with over 3 years of use being most concerning. Many experts recommend limiting Forteo treatment to 2 years or less whenever possible.
Periodically reassessing your need for Forteo with your healthcare provider is wise.
Staying Safe While Using Forteo
If you and your care team decide continuing Forteo is your best choice for managing severe osteoporosis, there are steps you can take to minimize ONJ risk:
Good Oral Care
Practicing excellent oral hygiene and getting regular dental checkups helps prevent dental diseases that seem to contribute to ONJ in those taking Forteo.
Avoid Invasive Dental Work
While taking Forteo, take a conservative approach to dental issues whenever possible. Avoid tooth extractions or implants if feasible.
Use Antibiotic Mouth Rinse
Your dentist may have you rinse daily with an antibacterial mouthwash designed to support gum and bone health in your jaws.
Stop Smoking
Quitting smoking immediately helps lower your chance of bone death in the jaw and other oral health issues.
Monitor for Signs of ONJ
If you notice possible ONJ symptoms like jaw swelling, pain, numbness or loosening teeth, seek prompt evaluation.
Early detection allows quicker treatment and prevention of additional complications.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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