Osteoporosis medications and oral health.pages
Osteoporosis Medications and Oral Health
Because some medications can affect your oral health or your dental treatment plan, your dentist should know about al the medications that you take. For example, antiresorptive agents (which include
bisphosphonates), can influence dental treatment decisions. These types of medications may be used to prevent or treat osteoporosis (a thinning of the bones) or as part of cancer treatment. They also are used
to treat Paget’s disease of the bone.
Some antiresorptive agents (such as Fosamax, Actonel, Atelvia, Didronel, Boniva) are taken oral y
(swal owed) to help prevent or treat osteoporosis and Paget's disease of the bone. Others, such as Boniva IV, Reclast or Prolia, are administered by injection. Higher and more frequent dosing of these
agents are given as part of cancer therapy to reduce bone pain and hypercalcemia of malignancy (abnormal y high calcium levels in the blood) associated with metastatic breast cancer, prostate cancer
How do these medications affect dental treatment plans?
These medications have been associated with a rare but serious condition cal ed osteonecrosis (OSS-tee-oh-ne-KRO-sis) of the jaw (ONJ) that can cause severe damage to the jawbone.
While osteonecrosis of the jaw can occur spontaneously, it more commonly occurs after dental procedures that affect the bone or associated tissues (for example, pul ing a tooth). Your dentist can tel
you if the proposed treatment involves these tissues.
Am I at risk?
It’s not possible to say who wil develop osteonecrosis and who wil not. Most people (94 percent) diagnosed with ONJ associated with these medications are patients with cancer who are receiving or
have received repeated high doses through an infusion. The other 6 percent of people with ONJ were receiving much lower doses of these medications for treatment of osteoporosis.
It may be beneficial for anyone who wil be starting osteoporosis treatment with antiresorptive agents to see their dentist before beginning treatment or shortly after. This way, you and your dentist can ensure
that you have good oral health going into treatment and develop a plan that wil keep your mouth healthy during treatment.
Should I cancel or postpone dental treatments?
Patients who take antiresorptive agents for the treatment of osteoporosis typical y do not need to avoid or
postpone dental treatment. The risk of developing osteonecrosis of the jaw is very low. By contrast, untreated dental disease can progress to become more serious, perhaps even involving the bone and
associated tissues, increasing the chances that you might need more invasive treatment.
People who are taking antiresorptive agents for cancer treatment should avoid invasive dental treatments,
if possible. Ideal y, these patients should have a dental examination before beginning therapy with antiresorptive agents so that any oral disease can be treated. Let your dentist know that you wil be
starting therapy with these drugs. Likewise, let your physician know if you recently have had dental treatment.
Should I stop taking my medication?
It is not general y recommended that patients stop taking their osteoporosis medications. The risk of
encountering bone weakness and a possible fracture are higher than those of developing osteonecrosis. You should talk to your physician before you stop taking any medication.
What are the symptoms of osteonecrosis of the jaw?
Symptoms include, but are not limited to:
pain, swel ing, or infection of the gums or jaw
injured or recently treated gums that are not healing
numbness or a feeling of heaviness in the jaw
Contact your dentist, general physician or oncologist right away if you develop any of these symptoms
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