DEAR DR. GOTT: I was diagnosed with dead bone in my jaw in June 2009. It is actually in the large torus palatinus, on the roof of my mouth. My oral surgeon is convinced it was caused by my taking Actonel or Boniva for osteoporosis for seven years. My family physician wasn’t so convinced the Boniva caused this.
The first step by the oral surgeon was to take me off Boniva. He said we would only watch the exposed bone for six months, that there was a chance the bone would fall out on its own. When he wanted my family physician’s permission to go off the Boniva and I got it, I learned my physician was not so sure about it.
After eight months, the bone has grown down, and some has chipped off. Last week, the oral surgeon pulled an area the size of a lima bean out. The current plan is to continue to watch it in the hope the dead bone comes out completely on its own in the next four months. He told me all along it would be a year before he would consider it safe to do surgery if any of the bone needs to be removed. Half the torus palatinus has effectively dissolved. He indicated we might want to consider removing the other half to prevent bone from dying there. I would like to avoid surgery if I can.
I take good care of my teeth, and I am a 62-year-old female who runs, lifts weights, takes calcium, and tries to do all the right stuff to prevent further damage to my bones from osteoporosis. What do you think of the idea of removing the other half of the torus palatinus?
DEAR READER: The torus palatinus is a benign bony growth known as an exostosis located in the middle of the hard palate in the roof of the mouth. Generally, it doesn’t require treatment unless it becomes so large it interferes with function or dental placement. In fact, the most common reason for surgical removal is that dentures do not fit well. The procedure is relatively simple.
I am well aware of the issues of necrotic bone from medications taken to fight osteoporosis. The issue came to light several years ago and even today prevents a great number of women from taking the recommended medications.
I can offer my personal opinion but must defer to your oral surgeon regarding surgical removal of the half torus palatinus that remains. If the necrotic (dead) bone ejects on its own, your problems are likely solved. If not, speak with another surgeon for a second opinion and guidance on what the best course of action is for your situation. I know this isn’t what you want to hear, and the waiting must be terribly frustrating.
Some considerations are whether any sharp projections interfere with eating and talking, and whether you constantly irritate your tongue if there are projections. Good luck.
To provide related information, I am sending you copies of my Health Reports “An Informed Approach to Surgery” and “Osteoporosis.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order for each report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s) or print an order form off my website at www.AskDrGottMD.com.
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