Two studies suggest that the drug teriparatide, or Forteo, may help people who have lost bone in their jaw because of periodontal disease or osteonecrosis. 

Periodontal disease is severe, chronic inflammation of the gums that is a major cause of tooth loss. It affects 1 in 5 American adults, and it is seen more frequently in people with rheumatoid arthritis, or RA, than in the general population.

Osteonecrosis is the death of bone tissue, and it can occur as a rare side effect related to the use of bisphosphonates, drugs used to treat cancer and osteoporosis.

Teriparatide is an injectable form of parathyroid hormone. It has been approved by the U.S. Food and Drug Administration for several years as a treatment for osteoporosis. Unlike medications that treat bone loss by stopping bone breakdown, however, teriparatide works by spurring the growth of new bone.

In the New England Journal of Medicine, researchers from Melbourne, Australia present a case study of an 88-year-old woman who developed osteonecrosis of the jaw after taking the corticosteroid medication prednisolone for 20 years and the bisphosphonate drug alendronate, or Fosamax, for 10 years. 

She developed jaw wounds and suffered from pain for a year before agreeing to try teripartide. After eight weeks, her symptoms disappeared, and her osteonecrosis resolved.

Researchers say teriparatide appears to have healed the bone by stimulating new growth. But they stress this has been shown only in a few patients so they say a randomized, controlled trial is needed for further proof.

“Osteonecrosis of the jaw has been difficult to treat, but we hypothesize that teriparatide may be a novel effective treatment, which requires further study,” says Dr. Ada Cheung, an endocrinologist at The University of Melbourne in Australia. 

“If teriparatide was proven in a randomized controlled trial to heal osteonecrosis of the jaw, this would be a significant advance as there are currently no good treatments for osteonecrosis of the jaw," Dr. Cheung says. "Patients can have painful symptoms for years and often require multiple surgical procedures to clean the infected bone as well as prolonged courses of antibiotics."

A second study reported in the same journal tested teriparatide for the first time in the treatment of bone loss in the mouth caused by periodontal disease.