Osteonecrosis of the Jaw (ONJ)

A diagnosis is made by a dentist or a physician. Signs may include:

• Loosening of a tooth/teeth
• Swelling of soft tissue (e.g. gums)
• Infection of soft tissue (e.g. drainage)
• Tooth or jaw pain (e.g. jaw feels heavy or numb)
• Exposed bone in jaw area

Please inform your physician/nurse promptly if you experience any of the symptoms listed above. Contact the call centre at 519-749-4380 Monday to Friday from 8:30am to 4:00pm. Note: we are closed statutory holidays.

• Have a thorough dental examination and complete any required work before bone modifying therapy begins, if possible. Keep your dentist informed of what drug you are taking. You can continue to have dental cleaning and fillings.
• Avoid elective or surgical procedures in the mouth during treatment with bone modifying therapy (e.g. dental extraction, crown lengthening surgery). It is better to try and keep existing teeth and roots if you are able to.

While on therapy, please speak to your physician/nurse prior to having urgent or elective dental/oral procedures done. Planning has to occur for how long you are to be off of your medication before and after your procedure, what antibiotic therapy you need and a mouth rinse to use.

• Practice good oral care:
• Stop smoking;
• Avoid excessive alcohol consumption;
• Maintain a diet which reduces risk of cavities (e.g. less sugar);
• Keep mouth moist with water (lowers risk of decay);
• Brush teeth after meals and at bedtime;
• Floss your teeth daily, unless advised not to by your physician;
• Check your teeth and gums daily in the mirror;
• Have denture fit checked regularly in case adjustments are needed to avoid irritation or trauma. Dentist should also check oral health;
• Have dental examinations every six to12 months (routine cleaning and fillings are safe); and
• Contact your dentist promptly for any suspicious symptoms or changes in your oral health.