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Archive for January 9th, 2009

Cross Posted from Flap’s Dentistry Blog


A new study coming out of Flap’s alma mater, the University of Southern California School of Dentistry has reported an increased incidence in the occurrence of osteonecrosis of the jaw among patients taking oral bisphosphonates, including Fosamax, Actonel and Boniva.

In a separate report Thursday in the Journal of the American Dental Assn., Parish Sedghizadeh of the USC School of Dentistry reported that he had observed nine cases of osteonecrosis of the jaw among 208 patients taking oral bisphosphonates — an unusually high incidence.

Osteonecrosis of the jaw — death of the bone — is known to occur in 1% to 10% of cancer patients taking intravenous bisphosphonates to combat bone weakening brought on by chemotherapy. It is rarely observed in patients taking oral forms of the drug, however.

Some people immediately dismissed his findings, arguing that the widespread use of the drugs would have already revealed such a high incidence of a disabling side effect.

“The most important criticism is that the sample size was only 208 patients,” said Dr. Robert R. Recker, director of the Osteoporosis Research Center at Creighton University in Omaha and president of the National Osteoporosis Foundation. “The study design and sample size were simply inadequate to make any conclusions.”

Both the American Society for Bone and Mineral Research and the American Dental Assn. have recently conducted comprehensive reviews of the risks of osteonecrosis associated with oral bisphosphonates, added Dennis Black, a professor of epidemiology and biostatistics at UC San Francisco. They concluded “that the risk is somewhere between 1 in 10,000 and 1 in 100,000, and it is not clear that this is increased by bisphosphonates,” he said.

The American Dental Association today issued the following advisory which is here.

Most noteworthy from the advisory:

  • The American Dental Association has reviewed previous studies on this issue which indicate that use of oral bisphosphonates (medication commonly prescribed for patients with osteoporosis) has been associated with a low risk for developing ONJ-one study indicated 1 out of 2,260 people taking oral bisphosphonates develop ONJ. This new study from USC claims that the frequency of ONJ among oral bisphosphate users is higher than previously reported-approximately 4 percent of the people studied.
  • It’s important for me to know if you are on bisphosphonate drugs or if you’ve used them in the past because of the possible risk of developing ONJ. ONJ is uncommon, but it can be serious. If you have received bisphosphonate therapy intravenously related to cancer therapy, you may be at a higher risk of developing ONJ than if you take oral medication.
  • Current ADA recommendations suggest that routine dental treatment generally need not be altered merely because a patient is taking or has taken oral bisphosphonates. However, patients with any history of bisphosphonate therapy should be especially encouraged to practice optimal oral hygiene and to receive routine dental examinations. Furthermore, a comprehensive oral examination and treatment before or soon after commencing bisphosphonates therapy may be beneficial for patients if they’re not already receiving regular dental care to treat existing oral health problems

A previously issued patient handout is available for download here (pdf).

This is a controversy which will be further studied.

In the meantime, Flap urges caution for patients taking ORAL Bisphosphonate medications. And,please patients update your health history and tell your dentist if you are using these drugs.


Dentistry Today: Bisphosphonates: Zometa (zoledronic acid) & Aredia (pamidronate disodium) Associated with Osteonecrosis of Jaw – REDUX

Bisphosphonates: Zometa (zoledronic acid) & Aredia (pamidronate dis odium) Associated with Osteonecrosis of Jaw

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David Shuster of MSDNC (MSNBC) Vs. John Ziegler on Sarah Palin’s complaints about media bias

Flap thinks Sarah Palin’s latest foray into the biased media world borders on whining. Nobody likes a whining POL.

Time for the Alaska Governor to concentrate on the future and policy issues rather than the “poor ol’ me” routine.

She is better than this John Ziegler exploitation moment and besides there are plenty of surrogates who can bash Shuster, Matthews and Olbermann over at MSDNC. Remember Shuster’s glee at the Palin Thanksgiving Turkey pardon-slaughter news conference?

Enjoy the clip above anyway.

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Day By Day 010909

Day By Day by Chris Muir

The Senate Democrats and Harry Reid in particular now are in a quandry with today’s ruling by the Illinois Supreme Court.

The Illinois Supreme Court says Secretary of State Jesse White doesn’t need to sign Roland Burris’ appointment to the U.S. Senate to make it valid.

The ruling says no Illinois official has to do anything further to validate the appointment made by Gov. Rod Blagojevich.

Burris was refused President-elect Barack Obama’s vacant Senate seat this week in part because Senate

Democratic leaders said his paperwork was incomplete without White’s signature.

The state Supreme Court says nothing in state law requires White to sign the appointment.

White has said he wouldn’t certify any Blagojevich appointment in the wake of the governor’s federal corruption arrest unless the court forced him to.

Roland Burris should force Harry Reid’s hand and immediately file suit in the United States Supreme Court demanding that he be seated.

Roland Burris will win and so will Illinois Governor Hot Rod Blagojevich who was impeached today.


The Day By Day Archive

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Comments Comments Off on Day By Day by Chris Muir January 8, 2009 – Let’s Be Up Front

  • Sen. John McCain doesn’t want to talk about the presidential campaign, and he certainly doesn’t want to discuss Sarah Palin.

    But two months after losing the presidential race, the “old John McCain” is back, hammering away on government reform, earmarks and wasteful government spending.
    McCain has been taking a very low-key approach to his Senate job since the presidential election. The Arizona Republican has made clear that he will seek reelection in 2010, and he recently created a leadership PAC to help bolster his fundraising profile. Other than that, McCain has deliberately avoided the limelight.

    During a GOP-senators retreat this week at the Library of Congress, McCain told his colleagues that Republicans need to reach out more to diverse groups, rather than just relying on Christian conservatives, if they want to regain majority status, according to sources who attended the event.
    McCain will soon be badmouthing Palin – just give him a few months.

    (tags: mccain)
  • President-elect Barack Obama is preparing to scrap the way President Bush oversaw domestic security in the White House and name a former Central Intelligence Agency official to coordinate counterterrorism, people close to the transition said Wednesday.
    The ONe wants John O. Brennan and makes a position available for him.
  • The incoming Obama administration is prepared to abandon President Bush's doctrine of isolating Hamas by establishing a channel to the Islamist organisation, sources close to the transition team say.

    The move to open contacts with Hamas – which could be initiated through the US intelligence services – would represent a definitive break with the Bush presidency's ostracising of the group.
    american Jews ain't going to be too happy, now will they?

    (tags: Israel Hamas)
  • CA Insurance Commissioner Steve Poizner has reached beyond the California political sphere to hire a pair of national political veterans to guide his run for governor in 2010.

    Poizner today announced the hiring of Stuart Stevens and Russ Schriefer, veterans of President Bush's campaigns and those of more than a half-dozen GOP governors, as his lead strategists and media consultants.

    Poizner former top political adviser, Wayne Johnson, will remain as a senior strategist.


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