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Building Better Bones

In Issue:

I’ve been taking the osteoporosis drug Actonel for five years. It has helped my hips and spine, but a dental report suggests that it is harming my jawbone. Are alternative drug treatments available? My doctor suggests I see an endocrinologist.


It is good advice to discuss your treatment options with an endocrinologist—who specializes in hormones, minerals, and bone health—especially when any standard drug therapies for osteoporosis are worrisome or ineffective.

Alternative prescription therapies for osteoporosis may include Evista (tablets with estrogen-like action), Forteo (an injectable form of synthetic parathyroid hormone), and Calcitonin (a nasal spray or injectable form of a hormone involved in calcium metabolism).

Osteonecrosis (bone death) of the jaw, or ONJ, is a very rare complication of bisphosphonate drugs (including Actonel, Fosamax, Boniva, and Reclast) which, when it occurs, typically follows a tooth extraction or other trauma to the jaw, says Dr. Arnold Moses, distinguished service professor of medicine and director of the osteoporosis center located in the Joslin Center at the SUNY Upstate Medical University in Syracuse, New York, and his colleague Dr. Jennifer Kelly, assistant professor of medicine, who explain:

“To avoid ONJ, people taking bisphosphonates are advised to get regular dental checkups and to inform their dentist of all their medications. Authoritative groups emphasize that, in the majority of people with osteoporosis, the value of preventing fractures with bisphosphonates far outweighs the risk of ONJ, since the lifetime risk of an osteoporotic fracture can be up to 50 percent.”

To optimize drug therapy and protect bones for life, experts also recommend the following:

Get at least 1,200 mg of calcium and 1,000 IU of vitamin D daily from foods and supplements.

Walk, dance, or do other weight-bearing exercise regularly.

Don’t smoke.

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