Side Effect: Jaw pain

What is Jaw pain?

Jaw pain refers to pain in the jawbone.

In patients with cancer, jaw pain may be a symptom of osteonecrosis of the jaw (ONJ).

What does Jaw pain look like?

The symptoms of jaw pain may or may not be able to be seen. If the jaw is infected, redness, inflammation, ulcers, or an abscess may be seen.

The symptoms of osteonecrosis of the jaw (ONJ) may include:

• localized jaw pain
• swelling and inflammation
• loose teeth
• drainage
• eroded gum, with exposed jawbone

Some patients may experience local neurological complaints such as jaw numbness or a heaviness feeling in their jaw. Symptoms may occur at the site of a previous dental procedure, but may also occur in other areas and without a recent visit to the dentist.

Who gets Jaw pain?

Risk factors for jaw pain from ONJ include:

• radiation to the head and neck
• periodontal disease
• dental procedures involving bone surgery
• trauma from poorly fitting dentures

Patients with cancer may receive certain treatments that can increase risk of ONJ such as:

• Denosumab (Xgeva®, Prolia®)
• Zoledronic acid (Zometa®, Reclast®)
• Pamidronate (Aredia®)
• Cabozantinib (Cabometyx®, Cometriq®)
• Lenvatinib (Lenvima®)
• Sunitinib (Sutent®)
• Bevacizumab (Avastin®, Mvasi®, Zirabev®)
• Corticosteroids:
  • prednisone (Deltasone®)
  • dexamethasone (Decadron®)
  • methylprednisolone (Medrol®, Solu-Medrol®)

How to prevent Jaw pain

Preventing jaw pain, including, ONJ involves regular dental visits, good oral hygiene, and addressing any pre-existing dental problems prior to starting treatments that may increase your risk.

How to treat Jaw pain

• For any type of jaw pain, antibiotics may be indicated if there is concern for an active infection.
• If ONJ is thought to be medication related, the first step is often to stop the causative agent
  • If there is exposed bone, a cover can be placed over the area to protect the bone.
• Finally, in severe cases, surgery may be indicated.