Good For Your Hips, Potentially Bad For Your Jaw: Understand How Bisphosphonates Can Affect Your Dental Health

Dentist Blog

If you have been diagnosed with osteoporosis, your primary care physician may discuss the option of using one of the bisphosphonate drugs as part of your treatment plan to increase your bone density and strengthen your bones. Since the National Osteoporosis Foundation estimates that half of all women who are 50 years of age or older and have osteoporosis will sustain a broken bone, this medication seems like a great idea. Like all drugs, however, bisphosphonates are not without side effects. Be sure to educate yourself on the potential side effects of these medications, particularly a rare and serious one that can impact your dental health.

What Are Bisphosphonates?

Bisphosphonates are antiresorptive drugs, which means that they slow the deterioration of bone tissue. These medications are used to treat osteopenia, osteoporosis and other diseases that reduce bone density and strength. The benefits of bisphosphonate therapy are the following goals:

  • To retard the progression of osteoporosis
  • To enable bone to increase in density and become less brittle
  • To reduce the risk of bone fractures

As the influx of television advertisements featuring baby boomer celebrities suggests, there are several bisphosphonates on the pharmaceutical market. Depending on which medication your physician has prescribed, bisphosphonates are either taken orally on a daily, weekly or monthly basis or administered intravenously on a periodic schedule. Bisphosphonates seem like a boon for anyone who is striving to retain mobility and independence throughout their golden years. For some, however, the potential for one side effect may be a deal breaker.

What Is Osteonecrosis of the Jaw?

Osteonecrosis of the jaw occurs when the alveolar bone is starved of oxygenated blood and dies off. Osteonecrosis of the jaw can result from bisphosphonate therapy, steroidal medication use, radiation treatments to the jaw and some cancer treatment drugs. Intravenously administered bisphosphonates carry a higher risk for osteonecrosis of the jaw than those taken orally. While osteonecrosis of the jaw is not a common side effect, the risk increases over the course of long-term bisphosphonate therapy and is higher in individuals who undergo an invasive dental procedure. Some additional factors that can increase the risk include the following:

  • Gum wounds or irritation, such as those caused by injury or by ill-fitting dentures
  • Poor oral hygiene
  • Smoking
  • Excessive alcohol consumption
  • Having diabetes

Signs of Osteonecrosis of the Jaw

If you are taking bisphosphonates, pay attention to what is going on in your mouth. If you experience any of the signs or symptoms of osteonecrosis of the jaw, be sure to report them to your dentist as soon as possible. The signs include the following:

  • Gum wounds that are slow to heal
  • Pain or swelling of the gums or jaw
  • Loose teeth
  • Jaw numbness
  • Jaw abscesses that are draining pus

Although there is no specific test for diagnosing osteonecrosis of the jaw, your dentist will be able to assess your symptoms and make a diagnosis based on radiographs and an oral examination.

How Is Osteonecrosis of the Jaw Addressed?

Once your dentist determines that you have osteonecrosis of the jaw, the goal of treatment will be to reduce oral pain and to prevent infection. If you ever require oral surgery, such as a tooth extraction, an alternative procedure may be pursued instead to increase your chance of proper healing. Be sure to inform your dentist if you are taking bisphosphonate drugs so that he or she can tailor your dental care accordingly. If you need an invasive oral procedure, you should notify your physician as well.

The more common side effects of bisphosphonates are tolerable and may be temporary, and the benefits of therapy outweigh the risks. If you are considering bisphosphonate therapy, see your dentist for a complete oral examination, to discuss how bisphosphonates may affect your dental health and to pursue all necessary oral surgery beforehand. Contact a dentist, like Kappenman Family Dental, if you have any concerns.


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Dentistry for the Whole Family

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