The Better Bones Blog

by Dr. Susan Brown, PhD.

Oral alendronate (Fosamax®) use seriously increases the risk of severe dental complications

For some time now we have been hearing reports of strange jaw bone decay (osteonecrosis) associated with the use of Fosamax® and other bisphosphonate osteoporosis drugs including Actonel® and Boniva®. We have been told, however, that the risk of this frightful side effect (1) was extremely low (on the order of 1/1000 of a percent) and (2) involved those taking the bone drugs intravenously. As the dust clears and non-commercially financed studies are surfacing however, we see a different story. As recently reported by the University of Southern California Dental School in Los Angeles, the risk of jaw bone damage from oral bisphosphonate use is both real and significant.

This 2008 study looked at Dental School patients who were on, or had taken, Fosamax and who also were being treated for active osteonecrosis of the jaw (a “rotting” or death of jaw bone tissue). The study identified 208 patients with a history of Fosamax use and found that 4% of these had active osteonecrosis of the jaw. All osteonecrosis cases occurred after either simple tooth extraction or denture trauma that resulted in jawbone exposure. In 4% of all cases, the jaw was simply not able to heal itself from the trauma of tooth extraction or other injury. This is not an insignificant number and it is a far cry from the 1/1000 of a percent risk previously suggested by medical authorities. On the other hand, of the University’s 13,522 patients without a history of Fosamax use, 4,384 underwent tooth extraction without a single development of post-surgery jaw osteonecrosis.

From the Better Bones Perspective, this is not at all surprising. There are likely many mechanisms by which these osteoporosis drugs damage the self-repair capacity of bone. For one, the drugs greatly reduce not only the unwanted bone breakdown, but they also equally reduce the desired new bone build-up. This curtailing of bone renewal limits the self-repair, self-renewal process of bone breakdown and build-up. The development of “jaw rotting” after jaw bone trauma is one manifestation of this severe repair deficit.



Sedghizadeh, PP, et al. 2009. Oral bisphosphonate use and the prevalence of osteonecrosis of the jaw: An institutional inquiry. J Am Dent Assoc, 140(1):61-66.

Welcome to the Osteo Blast (now the Better Bones Blog!)

Greetings to all,

Some of you might be wondering why you have not heard from me for several months—no newsletters, few e-mail notices. Well, over the past year I have been very busy writing numerous new articles for our redesigned web site, My goal was, and is, to produce the world’s most informative and useful website on natural bone health. I am very pleased with the new site and hope you like it too. I would love to hear your comments.

In these new articles, I’ve tried to share the many exciting developments in the field of bone health and to capture some of the things we know about bone health that are in contrast to the conventional wisdom about osteoporosis. One article that I’d like to share with you now is a summary of 10 major common myths about osteoporosis. In this article, “It’s More Than Just Thin Bone—The Top 10 Myths about Osteoporosis,” and on my entire web site, I work to sort fact from fiction, helping you to better understand the true nature, causes, and best prevention and treatment of osteoporosis and osteopenia.

It is great to be back in touch with you. I will be writing this blog every two weeks, highlighting the new science of bone health. Let me know what you think of the “The Top 10 Myths about Osteoporosis” and my new website.


Declining nutrient content of US foods

When we eat a carrot or apple today are we getting all the nutrients we have been told the food contains?  The answer is no.  According to the data collected by the USDA (U.S. Dept. of Agriculture), today we would need to eat five apples to get all the same nutrients that one apple contained in 1965. The same USDA data reported significant loss of minerals in both vegetables and fruits between 1940 and 1991. Some of the mineral reductions in vegetables and fruits were reported as below.

(Mineral Reductions from 1940 to 1991)


  • Potassium: -16%
  • Magnesium; -24%
  • Calcium; -46%
  • Zinc: -59%
  • Copper -76%
  • Iron: -27%
  • Sodium: -49


  • Potassium: -19%
  • Magnesium; -16%
  • Calcium; -16%
  • Zinc: -27%
  • Copper -20%
  • Iron: -20%
  • Sodium: -29

Many factors contribute to this loss of nutrient content. These factors include modern farm methods, soil depletion, the use of pesticides and herbicides, and imbalanced fertilizers.


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