Osteoporosis Drugs May Make Dental Procedures Difficult

Osteoporosis:

Osteoporosis may increase the severity of bone loss in periodontal disease. To assess your risk of gum disease, visit the American Academy of Periodontology.

Note, patients on medications to treat Osteoporosis may be at risk of bisphosphonate-associated osteonecrosis (BON) of the jaw (link).

Bisphosphonate Drugs, Osteoporosis, and Oral Osteonecrosis:

Bisphosphonates are a family of drugs used to treat bone problems like osteoporosis, osteopenia, and bone cancer. If an Oral Bisphosphonate Drug (Fosamax (alendronate sodium), Boniva (ibandronate), and Actonel (risedronate), etc) has been taken for more than three years, there are certain precautions we need to take prior to treatment. We will obtain a special test, called a CTX Test, to determine the potential for risk of developing bisphosphonate-associated osteonecrosis (BON) of the jaw after treatment. As long as the test is in a safe range, the risk of this complication is low. If you have taken these oral drugs for less than three years, then no test is necessary and we can proceed with your needed treatment.

The Intravenous (IV) Form of the Bisphosphonate Drugs Zometa (zoledronic acid), Aredia (pamidronate disodium), and Reclast (pamidronate disodium), are very potent drugs to treat bone cancer (such as multiple myeloma) or osteoporosis. These drugs are more likely to result in BON and limit the type of dental treatments available. At the exam, we can determine what types of treatment can and cannot be utilized.

Other drugs are available to treat osteoporosis – estrogen or hormone replacement therapy, selective estrogen receptor modulators (like Evista), Calcitonin Hormones (like Forteo SubQ and Miacalcin Nasi), and Anabolic medications (like parathyroid hormone). Ask your doctor about switching to a non-bisphosphonate drug.

To assess your risk of gum disease, visit the American Academy of Periodontology.