Osteoporosis Drugs And Dental Treatment
Some osteoporosis drugs can impair the jawbone causing problems during dental treatment.
Bisphosphonate drugs such as Boniva, Fosamax, Actonel, Zometa, Reclast, Aredia and Alendro can reduce the blood supply to the jawbone resulting in dead bone areas. The condition known formerly as ONJ is now referred to as Antiresorptive Drug Associated Osteonecrosis of the Jaw (ARONJ). When these dead bone areas become exposed following dental treatment that involves the removal of teeth, the damage to the jawbone can increase. Special tests, including CTX tests, are not reliable for diagnosing or predicting ARONJ, so patients and dentists may have difficulty predicting the risk of permanent damage.
Patients taking bisphosphonate drugs orally have a .1 -.4% risk of ARONJ while the risk to those taking injections increases significantly to 2-10%. Patients who are receiving injections should receive root canal treatment and/or conservative restorative treatment rather than extractions. Denture patients should consider new dentures to avoid irritation of the thin tissue that covers the jawbone to prevent ARONJ.
Dentists can take special precautions by using wound-closure techniques and prescribing special rinses pre- and post-operation. If a patient is able to take an osteoporosis medication that is not a bisphosphonate, extractions, periodontal treatment and dental implants should not be a problem.
Patients who know they will require dental treatment are encouraged to consider an osteoporosis treatment program with vitamins and minerals.
Adequate intake of vitamin D combined with calcium, magnesium, vitamin K2 and strontium are known to improve bone health without the risks associated with bisphosphonates... and at a much lower cost.