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Bone Health Glossary · Risk & causes

Osteonecrosis of the jaw

Also called: ONJ

Evidence
◆ Strong Clinical Evidence
Topic
Risk & causes
Taught in
Tier 2 · Lesson 7
In plain English

What it means

Osteonecrosis of the jaw (ONJ) is a rare condition where part of the jawbone loses blood supply and fails to heal, sometimes linked to long-term use of certain bone medications.

Why it matters for your bones

Knowing about this rare risk helps you have informed conversations with your prescriber and dentist if you're on long-term bisphosphonate therapy.

Osteonecrosis of the jaw, often shortened to ONJ, is a rare condition where an area of jawbone loses its blood supply and doesn't heal properly, sometimes leading to exposed bone in the mouth. It's recognized as one of the uncommon complications linked to certain bone medications, particularly bisphosphonates like alendronate, risedronate, and zoledronic acid, when used over a long duration.

The connection makes sense given how these drugs work: bisphosphonates bind to bone mineral and get taken up by osteoclasts, slowing down the normal process of bone breakdown. This is generally helpful for reducing fracture risk, but it also means bone turnover in certain areas, including the jaw, can be affected differently over long periods of use.

It's worth knowing that this is described as a rare complication, not a common one, and it's associated primarily with long-duration bisphosphonate use rather than short-term treatment. If you're on one of these medications and have questions about your dental health, risk factors, or how long you've been treated, that's a conversation to bring to your prescriber rather than something to manage on your own.

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Evidence

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The research behind this
Strong Clinical Evidence

Graded Strong Clinical Evidence: Supported by multiple well-designed clinical studies in humans. Read each study with its grade in mind. One study is a piece of the picture, not the whole of it.

1 peer-reviewed study, free with an Academy login
✦ The aha

ONJ is a rare jawbone risk sometimes linked to long-term bisphosphonate use, worth discussing with your dentist and prescriber.

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Where this leads

286 discoveries so far
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Since ONJ is linked to certain bone medications, see how bisphosphonates actually work and why they're prescribed despite this rare risk.

Bisphosphonate
Take me there Strong Clinical Evidence
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Where the Academy teaches it

This page is the short version. The lessons teach it in full, with the context around it and a quiz to lock it in.

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Education only, not medical advice. Decisions about tests, medications and treatment belong with your own doctor. OsteoStrong does not diagnose, treat or cure any disease.

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