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Posts for tag: osteoporosis

By Josephine Chianello Berman, D.D.S.
December 21, 2021
Category: Oral Health
Tags: oral health   osteoporosis  
SomeOsteoporosisTreatmentsCouldImpactDentalCare

Millions of Americans live with osteoporosis, a degenerative bone disease that can turn a minor fall into a potential bone fracture. Literally meaning "porous bone," osteoporosis causes the natural marrow spaces in bone tissue to progressively grow larger and weaken the remaining bone.

Many osteoporosis patients take medication to slow the disease's process. But due to the dynamic nature of bone, some of these drugs can have unintended consequences—consequences that could affect dental care.

As living tissue, bone is literally "coming and going." Certain cells called osteoblasts continuously produce new bone, while others called osteoclasts remove older tissue to make way for the new. Drugs like bisphosphonates and RANKL inhibitors interrupt this process by destroying some of the osteoclasts.

As a result, more of the older bone remains past its normal lifespan, helping the bone overall to retain strength. But ongoing research is beginning to hint that this may only be a short-term gain. The older, longer lasting bone is more fragile than newer bone, and tends to become more brittle and prone to fracture the longer a patient takes the drug. This tissue can also die but still remain intact, a condition known as osteonecrosis.

The femur (the large upper leg bone) and the jawbone are the bones of the body most susceptible to osteonecrosis. Dentists are most concerned when this happens in the latter: Its occurrence could lead to complications during invasive procedures like oral surgery or implant placement.

Because of this possibility, you should keep your dentist informed regarding any treatments you're undergoing for osteoporosis, especially when planning upcoming dental procedures like oral surgery or implant placement. You might be able to lower your risk by taking a "drug holiday," coming off of certain medications for about three months before your dental work.

As always, you shouldn't stop medication without your doctor's guidance. But research has shown drug holidays of short duration won't worsen your osteoporosis. If you're already showing signs of osteonecrosis in the jaw, a short absence from your prescription along with antiseptic mouthrinses and heightened oral hygiene could help reverse it.

Fortunately, the risk for dental complications related to osteoporosis medication remains low. And, by working closely with both your dentist and your physician, you can ensure it stays that way.

If you would like more information on osteoporosis and your dental care, 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 Drugs & Dental Treatment.”

By Josephine Chianello Berman, D.D.S.
April 05, 2021
Category: Oral Health
Tags: osteoporosis  
CertainDrugsforOsteoporosisCouldImpactYourDentalCare

Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.

From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.

Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.

These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.

Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.

Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.

If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown.  If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.

Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.

If you would like more information on osteoporosis and dental 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 Drugs & Dental Treatment.”