MRONJ: What It Is, Why It Happens, and How to Prevent It

When you hear MRONJ, Medication-Related Osteonecrosis of the Jaw, a condition where jawbone tissue dies due to certain drugs. Also known as drug-induced jaw necrosis, it’s not common—but when it happens, it’s serious and often preventable. This isn’t just a dental issue. It’s a side effect tied to powerful medications used for cancer, osteoporosis, and other chronic conditions.

Most cases of MRONJ happen after dental procedures like extractions or implants in people taking bisphosphonates, a class of drugs that slow bone breakdown, often prescribed for osteoporosis and bone metastases. Drugs like zoledronic acid and alendronate are common culprits. But it’s not just bisphosphonates—denosumab, a monoclonal antibody used to treat bone loss and some cancers can cause it too. These drugs stop bone remodeling, which sounds good for keeping bones strong, but it also means damaged bone can’t heal properly. If your jaw gets injured—even slightly during a routine cleaning—the bone can start dying.

People on long-term IV bisphosphonates for cancer have the highest risk. But even those taking oral versions for osteoporosis aren’t immune. The key isn’t avoiding medicine—it’s managing risk. That’s why dentists now ask about your meds before pulling teeth. If you’re on one of these drugs, don’t skip dental checkups. Let your dentist know exactly what you’re taking. Early signs? A sore spot that won’t heal, exposed bone in your mouth, numbness, or swelling. Catch it early, and treatment can be simple. Wait too long, and you could need surgery or lose part of your jaw.

What you’ll find in the posts below isn’t just theory. These are real, practical stories and guides from people who’ve dealt with this. You’ll learn how to talk to your doctor about switching meds safely, what dental prep looks like before starting treatment, how to spot warning signs before they turn into emergencies, and why some people never develop MRONJ even while on the same drugs. There’s no magic fix—but there are proven steps to protect yourself. This isn’t about fear. It’s about control. You don’t have to guess what’s happening to your body. The information is here. You just need to know where to look.