Posts for tag: osteoporosis

By James C. Palmer, DDS
March 20, 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.”

By James C. Palmer, DDS
April 02, 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.”



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James C. Palmer, DDS

(318) 927-6152
729 West Main Street Homer, LA 71040