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Posts for tag: osteoporosis

By Warren and Reese Family Dentistry
September 09, 2014
Category: Oral Health
Tags: osteoporosis  
CertainDrugsTakenforOsteoporosisCouldAffectDentalCareOutcomes

If you have osteoporosis, one of the drugs you may be taking is alendronate, more commonly known by the brand name Fosamax®. Alendronate is a member of the bisphosphonate drug family, which inhibit bone resorption (the loss of bone mass). While an effective treatment of osteoporosis, alendronate may cause an opposite side effect in other areas of the body, the inhibition of new bone growth. This effect on the jaw in particular could result in an adverse reaction after dental surgery.

The main concern is a condition called osteonecrosis, or literally “bone death.” Bone tissue normally goes through a cycle of resorption (the dissolving of bone tissue) and new growth to replace the cells that have been lost through resorption. Osteonecrosis disrupts the growth phase so that the bone doesn’t recover properly after resorption. This results in the bone becoming weaker and less dense.

There have been a number of cases of increased osteonecrosis in patients on alendronate after experiencing trauma to the mouth. This includes dental surgery, particularly tooth extractions. In addition, patients with certain risk factors like diabetes, tobacco use or corticosteroid therapy appear more vulnerable to osteonecrosis.

Although the risk of osteonecrosis after dental surgery is small, many dentists recommend stopping the use of alendronate for three months before the procedure if you’ve been taking the drug for more than three years. This recommendation is based on a number of studies that seem to indicate three or more years of bisphosphonates therapy makes patients especially vulnerable to osteonecrosis. These studies also indicate stopping the therapy for three months significantly reduces the risk of developing the condition.

There’s still much to be learned about this link between alendronate therapy and dental health. It’s a good idea, then, to let us know what medications you’re taking (especially bisphosphonates) whenever you visit us for an exam. Knowing all your medications will help us develop the safest and most effective treatment plan for your dental care.

If you would like more information on bisphosphonates and their effect on oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fosamax and Surgery.”

By Warren and Reese Family Dentistry
May 16, 2014
Category: Oral Health
Tags: osteoporosis  
YourOsteoporosisTreatmentCouldAffectYourToothRestorationOptions

Your skeletal system plays an essential role in your physical well-being. Not only do bones physically support the body and protect internal organs, they also store minerals, produce blood cells and help regulate the body’s pH balance.

As dynamic, living tissue, bone goes through a normal cycle of removing old, ineffective areas (a process called resorption), followed by the formation of new bone to replace it. For most adults, the two sides of this cycle are roughly balanced. But with age and other factors, the scale may tip in favor of resorption. Over time the bone will become weaker and less dense, a condition known as osteoporosis.

One common approach in treatment for osteoporosis is a class of drugs known as bisphosphonates. Taken orally, bisphosphonates act to slow the bone’s resorption rate and restore balance to the bone’s natural regenerative cycle. But while effective for osteoporosis, it could affect your oral health, particularly if you are considering dental implants.

Long-term users of bisphosphonates can develop osteonecrosis, a condition where isolated areas of bone lose their vitality and die. This has implications for dental implants if it arises in the jawbone. Implants require an adequate amount of bone structure for proper anchorage; due to the effects of osteonecrosis, there may not be enough viable bone to support an implant.

Of course, the treatment for osteoporosis varies from patient to patient according to each particular case. Another effective treatment is a synthetic hormone called teriparitide, a manufactured version of a naturally occurring parathyroid hormone. Daily injections of teriparitide have been shown to slow resorption and stimulate new bone growth. And unlike bisphosphonates, researchers have found no link between the use of teriparitide and osteonecrosis.

If you are undergoing treatment for osteoporosis and are also considering dental implants, you should discuss the matter with your healthcare team, including your physician, dentist and dental specialists. Understanding how the treatment for your osteoporosis could affect your dental health will help you make informed decisions about your overall care and future dental needs.

If you would like more information on how osteoporosis may affect your oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Osteoporosis & Dental Implants.”