Osteonecrosis of the Jaw

Reviewed/Revised Dec 2022
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What is osteonecrosis of the jaw?

Osteonecrosis is the death of bone cells. Osteonecrosis of the jaw is the death of some cells in your jawbone.

  • Osteonecrosis of the jaw can happen on its own or after you have a tooth pulled or have a jaw injury

  • You may have pain and pus oozing from your mouth

  • Osteonecrosis of the jaw is treated with antibiotics, mouth rinses, and scraping away the dead bone

What causes osteonecrosis of the jaw?

Doctors aren't sure why people get osteonecrosis of the jaw. It can happen for no clear reason. But it's more likely after you've had:

  • A tooth pulled

  • A jaw injury

  • Radiation therapy to your head and neck to treat cancer

  • High doses of certain bone medicines directly into your vein (IV) called bisphosphonates

Bisphosphonates are most often taken by mouth to treat thinning bones (osteoporosis). Taking them this way doesn't seem to increase risk of osteonecrosis of the jaw. However, high doses given by vein may increase risk, particularly if you then have oral surgery.

What are the symptoms of osteonecrosis of the jaw?

Usually you'll have:

  • Pain

  • Pus in your mouth or jaw area

How can doctors tell if I have osteonecrosis of the jaw?

Your dentist or oral surgeon can tell whether you have osteonecrosis of the jaw based on your symptoms and an exam. There aren't any tests to confirm osteonecrosis of the jaw.

How can I prevent osteonecrosis of the jaw?

Before beginning IV bisphosphonate therapy, have a dental examination and get any oral surgery you need done first.

How do doctors treat osteonecrosis of the jaw?

An oral surgeon will treat osteonecrosis of the jaw with:

  • Surgery to scrape away the damaged parts of your jaw bone

  • Antibiotics

  • Mouth rinses

Doctors don't recommend taking out large areas of damaged bone as it may lead to even worse necrosis.

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