Phossy jaws : an old occupational disease - up to date?

Abstract

Recently a few reports of osteonecrosis of the jaws associated with a bisphosphonate therapy were published. There seemed to be some clinical commonalities with the old occupational disease "phossy jaws';. We give an historical and medical overview of "phossy jaws';. Because of many industrial changes that old disease has become rare; in Germany there are no cases reported in the years 1998 until 2002 — according to the German Hauptverband der gewerblichen Berufsgenossenschaften. Maybe the old knowledge about phossy jaws is able to clear up some secrets of the new drug-associated phenomenon.

First observations of phossy jaws date back to the years 1839 and 1843, they are seen with workers in match stick factories. The causality between phosphorus and phossy jaws was re-cognized in 1845. Phossy jaws are a consequence of endothelium-damage by elemental phosphorus inhaled when working with it. Especially the jaws are exposed to a number of foreign substances, i.e. bacteria by tooth decay or other circumstances. Thus — decreased blood flow and bacteria lead to an Osteomyelitis, so called phossy jaws.