Majority of Americans who take oral steroids for the treatment of inflammatory medical conditions do not receive additional therapy for possible side effects such as bone loss, international news agency Reuters reports, quoting findings from a 10-year research. Cleveland Clinic Foundation research coordinator Robert Overman was quoted as saying that the longer and greater a patient use oral steroids, the greater the risk of fracture. In oral steroid users who used the drug for over five years, only fewer that one in 10 was also using bisphosphonates to prevent osteoporosis. Dr. Ethel S. Siris mentions the guidelines requiring people to have a bone density test before using steroids. This should determine if the use of bisphosphonates are necessary. Alternative methods of treating bone loss should be considered by oral steroid users. This is because bisphosphonates, such as Fosamax, have the tendency to cause osteonecrosis of the Jaw (ONJ).