Doctors aren't sure why people get osteonecrosis of the jaw. It can happen for no clear reason. But it's more likely after you've had: A tooth pulled A jaw injury Radiation therapy to your head and neck to treat cancer High IV doses of certain bone medicines called bisphosphonates Bisphosphonates are most often taken by mouth to treat thinning bones ( osteoporosis ). Taking them this way doesn't seem to increase risk of ONJ. However, high doses given by vein may increase risk, particularly if you then have oral surgery.

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What is osteonecrosis of the jaw?

What causes ONJ?

What are the symptoms of ONJ?

How can doctors tell if I have ONJ?

How can I prevent ONJ?

How do doctors treat ONJ?

Osteonecrosis

Osteonecrosis of the Jaw

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Osteonecrosis of the Jaw

By

The Manual's Editorial Staff

Last full review/revision Feb 2021| Content last modified Feb 2021

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"Osteo" refers to bone. "Necrosis" is the medical term for dead cells. Osteonecrosis is the death of bone cells. Osteonecrosis of the jaw (ONJ) is the death of some cells in your jawbone. Many people don't think of bone as living, growing tissue but it is.

ONJ can happen on its own or after you have a tooth pulled or have a jaw injury
You may have pain and pus oozing from your mouth
ONJ is treated with antibiotics, mouth rinses, and scraping away the dead bone

Doctors aren't sure why people get osteonecrosis of the jaw. It can happen for no clear reason. But it's more likely after you've had:

A tooth pulled
A jaw injury
Radiation therapy to your head and neck to treat cancer
High IV doses of certain bone medicines called bisphosphonates

Bisphosphonates are most often taken by mouth to treat thinning bones (osteoporosis). Taking them this way doesn't seem to increase risk of ONJ. However, high doses given by vein may increase risk, particularly if you then have oral surgery.

Usually you'll have:

Pain
Pus in your mouth or jaw area

Your dentist or oral surgeon can tell whether you have ONJ based on your symptoms and an exam. There aren't any tests to confirm ONJ.

Before beginning IV bisphosphonate therapy, have a dental examination and get any oral surgery you need done first.

An oral surgeon will treat ONJ with:

Surgery to scrape away the damaged parts of your jaw bone
Antibiotics
Mouth rinses

Doctors don't recommend taking out large areas of damaged bone as it may lead to even worse necrosis.

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Osteonecrosis

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