Thought I would post this information in regards to Osteonecrosis…

Alendronate - bisphosphonate and “necrosis of the jaw”
It is a rare but serious side effect associated with bisphosphonate medications like alendronate.

Overview of Osteonecrosis of the Jaw (ONJ)
Osteonecrosis of the jaw (ONJ) is a condition where the jawbone dies and may become exposed in the mouth. It can occur after dental procedures or as a side effect of certain medications like bisphosanates.

Connection Between Alendronate and ONJ
Alendronate, a bisphosphonate medication, is associated with an increased risk of developing ONJ, especially in patients who:

Are on long-term treatment with alendronate.
Undergo dental procedures, such as tooth extractions.
Risk Factors for ONJ

The following factors can elevate the risk of ONJ in patients taking alendronate:
Duration of treatment: Longer use increases risk.
Dosage: Higher doses, particularly for cancer treatment, are more likely to lead to ONJ.
Dental health: Patients with periodontal disease or those requiring invasive dental work are at greater risk.
Symptoms of ONJ
Patients with ONJ may experience:
Exposed bone in the jaw for more than eight weeks.
Pain and swelling in the mouth.
Loose teeth and signs of infection.
Conclusion
Yes, alendronate can cause osteonecrosis of the jaw, particularly in patients receiving long-term treatment or undergoing dental procedures. Regular dental care and communication with healthcare providers are essential for managing this risk.

Source: rheumatology.org

Long-term use of alendronate is associated with a lower incidence of osteonecrosis of the jaw (ONJ) compared to other bisphosphonates like zoledronic acid. Studies indicate that ONJ occurs more frequently in patients treated with injectable bisphosphonates than in those receiving oral alendronate.
Sources: the-rheumatologist.org and hsa.gov.sg

Treatment of ONJ
Treatment for osteonecrosis of the jaw (ONJ) caused by alendronate typically involves conservative measures such as prescription mouth rinses, antibiotics, and pain management. In more severe cases, surgical removal of the dead bone may be necessary.
Cleveland Clinic
rheumatology.org

Treatment for Osteonecrosis of the Jaw (ONJ) Caused by Alendronate
Conservative Treatments
The initial approach to treating osteonecrosis of the jaw (ONJ) caused by alendronate typically includes:
Prescription Mouth Rinses: These help to maintain oral hygiene and reduce discomfort.
Antibiotics: Used to manage any infections that may arise in the affected area.
Pain Management: Analgesics are prescribed to alleviate pain associated with ONJ.
Surgical Interventions
In more severe cases of ONJ, where conservative treatments are insufficient, surgical options may be considered:
Surgical Removal of Dead Bone: This procedure may be necessary to remove necrotic tissue and promote healing.
Additional Considerations
Regular Dental Care: Maintaining good oral hygiene and regular dental check-ups can help prevent complications.
Informing Dentists: Patients should inform their dental care providers about their use of alendronate and any symptoms they experience.
These treatments aim to manage symptoms and promote healing while minimizing the risk of further complications associated with ONJ.
rheumatology.org
Cleveland Clinic