Zometa® (zoledronic acid) is a type of drug called a bisphosphonate that can help strengthen your bones. It’s often given to treat people who have a type of cancer called myeloma or who have a cancer that has spread to their bones (secondary bone cancer). Other bisphosphonates used to treat cancer in the bone include disodium pamidronate (Aredia ®) ibandronic acid (Bondronat®) and sodium clodronate (Bonefos®, Loron®).

Recently doctors have discovered that, uncommonly, bisphosphonates like Zometa can affect the jawbone, leading to areas of the jaw becoming damaged and dying. This is called osteonecrosis of the jaw. Most people taking bisphosphonate treatment will never develop this problem. So for most people the benefits of the treatment at preventing bone problems and treating pain outweigh the risk of jaw problems.

Usually osteonecrosis has developed when a person on bisphophonate treatment has had dental work done, especially a tooth taken out. So, to reduce the risk of this side effect doctors may suggest that you have a dental check up before starting treatment with bisphosphonates. This means a dentist can check your dental health and discuss with your cancer specialist if you need to have any dental work done before you have bisphosphonates.

You can also reduce your risk of jaw problems while taking bisphosphonates by keeping your teeth and gums healthy with a regular oral hygiene regime and seeing your dentist at least every year for a check up. This will help your dentist to prevent any problems with your teeth that might otherwise lead to a tooth needing to come out.

If in the future you need any dental treatment that might cause jaw problems your cancer specialist and dentist will discuss how to reduce your risk. This may involve:

• stopping bisphosphonate treatment for at least a month before the dental work
• only starting treatment again once your mouth has healed and you are fully recovered.

Very rarely osteonecrosis can develop during bisphosphonate treatment even if there has been no dental work done. The main symptoms in the mouth are: pain, swelling and redness of the gums, or teeth becoming loose. Less commonly, osteonecrosis can cause feelings of numbness or a ‘heavy jaw’. It’s important to let your dentist and cancer specialist know if you develop any of these symptoms and to mention that you are being treated with bisphosphonates.