Multiple oral ulcers caused by incorrect use of oral bisphosphonate in a patient with dementia: A case report

Abstract

It is not widely known that incorrect use of oral bisphosphonates (BPs), such as chewing the medication, can cause oral ulcers. An 83‐year‐old woman with dementia was referred to our clinic with multiple oral ulcers. Blood and histopathological examinations were inconclusive. Further questioning revealed that the patient chewed the oral BP, resulting in oral ulceration. Patients with loss of cognitive function, such as dementia, are at risk of oral ulcers caused by incorrect use of BPs.

Oral bisphosphonates: Adverse effects on the oral mucosa not related to the jaw bones. A scoping review

“…After reading the full text, another 16 articles were excluded. Finally, 26 studies were included in this scoping review 26,27,32‐59 (Figure 1).…”

“…In three cases, the age of the patient was not mentioned 27,51 . Ten cases involved patients who were residents of a nursing facility or were receiving 24‐hour help at home 43,44,50,54‐56,59 …”

“…Etidronate was administrated daily in four cases, 27,48 whilst in one case there was no information available concerning the dosage of etidronate 48 . Minodronate was administered monthly 54,56 . Risedronate was administered in one case weekly 27 and in the other case daily 48 …”

“…27,51 Ten cases involved patients who were residents of a nursing facility or were receiving 24-hour help at home. 43,44,50,[54][55][56]59 The major indication for prescribing bisphosphonates was osteoporosis (51/56). In one case, the bisphosphonate was administrated because osteopenia, a preosteoporotic condition.…”

Severe bisphosphonate‐related mucosa ulcerations in the oral cavity and upper aerodigestive tract

“…Bisphosphonates are widely used to manage osteoporosis, osteopenia, Paget's disease, bone metastasis of cancer, and multiple myeloma. 1 We report a patient with severe bisphosphonate-related oral/ esophageal mucosal disorder. Regarding monthly preparations of bisphosphonates, if patients consulting a medical institution with oral mucosal lesions present the prescriptions issued within 3 weeks as a recent prescription list, the drug name may not be included.…”