subject: Osteoporosis And Your Dentist [print this page] Osteoporosis is defined as the reduction in bone mass due to depletion of calcium and bone protein. It affects more than 10 million Americans over the age of 50, and more than 34 million are at risk for the disease. One out of every two women will sustain an osteoporosis-related fracture in her lifetime. Each year, osteoporosis causes 1.5 million new fractures. Of these fractures, 250,000 are hip fractures that result in death in more than 20 percent of women and 30 percent of men. Other risks include recurrent hospitalizations, increased office visits and often the need for care at extended treatment facilities. In individuals who have hip fractures, less than 25 percent of them regain full function. Talk to your doctor if you think you might be at risk for osteoporosis and ask about the benefits of oral bisphosphonates (like Fosamax, Actonel, and Boniva). Bisphosphonates are approved by the Food and Drug Administration (FDA) to help prevent fractures.
On the other hand, another medical term called osteonecrosis is bone damage that is extremely rare and occurs due to bone injury. The bone does not heal properly after the injury, and causes severe pain and swelling, then bone death. For example, osteonecrosis of the jaw could possibly occur in severe periodontal disease if a tooth needed to be extracted. In a situation with severe decay a simple extraction could possibly lead to the bone of the jaw not healing properly, and could result in extreme pain, inflammation, and further bone loss of the jaw.
It is thought that bisphosphonates may increase the incidence of osteonecrosis because they might slow healing and suppress bone turnover after a dental procedure. There are many commercials right now on the television by lawyers warning people about bisphosphonates. Lots of people are worried, but you should not be. The lawyers are trying to say that the class of medications used in treating osteoporosis, called bisphosphonates can cause osteonecrosis after a dental procedure. This is not true. Clinical trials do not support this with oral bisphosphonates; however, clinical trials do support this with intravenous bisphosphonates. In fact, the incidence for oral Fosamax, Actonel, or Boniva causing osteonecrosis occurs less than 1 case per 100,000 patients per year. About 94% of the cases of osteonecrosis are in cancer patients who are receiving intravenous (not oral) Zometa or Aredia (intravenous bisphosphonates). These specific IV medications are usually used in treating cancers that have spread to the bone.
Dr. Jason McCargar, DMD, of Scottsdale Dental Arts, said according to the ADA it is advised that patients notify their dentist if they are taking any bisphosphonate. He recommends that patients have routine dental exams before starting bisphosphonate therapy, again within 3 months after starting bisphosphonate therapy, then routinely every 6 months thereafter. Dr. McCargar also stresses that good dental hygiene can decrease the risk of osteonecrosis. He says that brushing and flossing your teeth twice per day can keep your gums and teeth healthy and prevent many dental procedures such as extractions. The Scottsdale dentist also says that bisphosphonates are considered by the medical community to be very safe medications and the benefits of using them far outweigh the risks for most patients.
by: Scottsdale Dental Arts
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