Hi, I had this infusion in April, I was told it could cause jaw problems but what I didn't know is that it can happen years after if have a tooth out jaw could collapse. At the moment I been to dentist and he has said one tooth that isn't very good should come out but he said he didn't want to because the jaw could collapse so what do you do ?
Hi Mere
Thanks for getting in touch through our ask a nurse platform. I’m Linda, one of the nurses from our support line. It’s good to see that you have joined some of our forums and I hope you are finding them helpful.
Unfortunately osteonecrosis of the Jaw (ONJ) can be a side effect of bisphosphonate treatments, which include Zometa (Zoledronic Acid).
ONJ is a condition which affects the jaw and can happen when a part of the jawbone loses its protection from the gum for more than 8 weeks. An example of this would be delayed healing from having a tooth removed. Though it is rare and is estimated to affect less than two percent of people having IV bisphosphonate treatment, it can be difficult to treat. This may be why there is a reluctance from the dentist to carry out any major work.
The UK Chemotherapy Board have these guidelines about medication related osteonecrosis of the jaw which recommend that:
dental problems may arise and if there appears an obvious cause of dental pain (for example a broken tooth or cavity) then it is reasonable for primary dental practitioners to assess patients in the first instance. Suspected MRONJ should be managed by specialist dental services. (Page 12)
In this instance the best of course of action is to discuss the problem with your oncology team. They should liaise with both you and your dentist to agree the best approach to take, and discuss whether a referral to a specialist dental or maxillofacial service is needed.
If you have a breast care nurse it is important to contact them or your oncologist’s secretary after the weekend for further guidance. And, though hopefully not, if you have any worsening dentals symptoms whilst you are waiting to speak to them the best approach would be to call your dentist or the 111 service for advice in the meantime.
I hope this helps, and if you’d like to speak further about this or anything else you are welcome to call or chat with us. You can phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.
Best wishes
Linda, Cancer Information Nurse Specialist
Ref: LM/LA
