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Oral Mucosal Ulceration Induced by Alendronic Acid: A Case Series Daniel Finn Anne Field Bijaya Rajlawat Christine Randall Dental Update 2024 45:1, 707-709.
Authors
DanielFinn
BDS(Hons), MFDS RCS(Ed), PGCert
Specialty Dentist in Oral Medicine, Liverpool University Dental Hospital, Liverpool, UK
A number of medications may cause oral ulceration by either systemic or local mechanisms. Alendronic acid tablets, when in prolonged contact with the oral mucosa, are one such medication. When prescribing alendronic acid tablets, it is important to ensure that the patient is able to take them correctly and, if this is not the case, that alternative methods of bone protection are considered. When patients present with oral ulceration, it is important to consider whether a medicine could be causing a localized tissue reaction. This case series highlights three cases of alendronic acid-induced oral ulceration.
CPD/Clinical Relevance: Practitioners should be aware of the potential oral unwanted effects of medications, including oral ulceration induced by prolonged mucosal contact with alendronic acid.
Article
Bisphosphonates are used to manage a number of conditions including; the treatment and prevention of osteoporosis, bone metastases, multiple myeloma and Paget's disease of the bone.1 Oral alendronic acid, the most commonly prescribed bisphosphonate used for the treatment and prevention of osteoporosis, acts to reduce bone resorption by inhibiting osteoclasts.2 Well recognized adverse effects of bisphosphonates include; osteonecrosis of the jaw and external auditory canal, as well as atypical femoral fractures.3 Alendronic acid is a frequently prescribed medication, with 8,758,501 prescriptions dispensed in the UK in 2015.4 Dental practitioners therefore need to be aware of the potential oral and dental adverse effects of this medication, including oral ulceration. The following three cases describe oral ulceration caused by alendronic acid when left in contact with the oral mucosa for a prolonged period of time.
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