Posts for: October, 2021
October 20th is World Osteoporosis Day, putting the spotlight on this degenerative bone condition and the impact it has on millions of people. Not only does it significantly increase the risk of potentially life-threatening fractures, but it can also indirectly affect dental health.
This connection arises from the use of certain treatment drugs that ultimately could lead to complications following some forms of dental work. These particular drugs, mainly bisphosphonates like Fosamax™ and RANKL inhibitors like Prolia™, destroy bone cells called osteoclasts, whose function is to clear away worn out regular bone cells (osteoblasts). With fewer osteoclasts targeting them, more older osteoblast cells survive longer.
In the short-term, a longer life for these older cells helps bones afflicted by osteoporosis to retain volume and density, and are thus less likely to fracture. Long-term, however, the surviving osteoblasts are less elastic and more brittle than newly formed cells.
In the end, these longer living cells could eventually weaken the bone. In rare situations, this can result in parts of the bone actually dying—a condition known as osteonecrosis. The bones of the body with the highest occurrences of osteonecrosis are the femur (the upper leg bone) and, of specific concern to dental care, the jawbone.
The effect of these medications on the jawbone actually has a name—drug-induced osteonecrosis of the jaw (DIONJ). Fortunately, there's only a 1% risk of it occurring if you're taking these drugs to manage osteoporosis. It's also not a concern for routine procedures like cleanings, fillings or crown placements. But DIONJ could lead to complications with more invasive dental work like tooth extraction, implant placement or periodontal surgery.
It's important, then, that your dentist knows if you're being treated for osteoporosis and the specific drugs you're taking. Depending on the medication, they may suggest, in coordination with your physician, that you take a "drug holiday"—go off of the drug for a set period of time—before a scheduled dental procedure to ease the risk and effects of osteonecrosis.
Because infection after dental work is one possible consequence of osteonecrosis, it's important that you practice thorough oral hygiene every day. Your dentist may also prescribe an antiseptic mouth rinse to include with your hygiene, as well as antibiotics.
You may also want to talk to your doctor about alternative treatments for osteoporosis that pose a lower risk for osteonecrosis. These can range from traditional Vitamin D and calcium supplements to emerging treatments that utilize hormones.
Osteoporosis can complicate dental work, but it doesn't have to prevent you from getting the procedures you need. Working with both your dentist and your physician, you can have the procedures you need to maintain your dental health.
If you would like more information about osteoporosis and dental care, please contact us or schedule a consultation.
There are few things sweeter to hear than for your dentist to tell you your periodontal (gum) disease is under control. Depending on how deep the infection may have advanced, your treatment journey may have been a long one.
Unfortunately, while the battle may be over, the threat still lingers—once you've experienced a gum infection, you're at higher risk for a recurrence. To minimize that risk, you may need to undergo dental cleanings on a more frequent basis than before.
The average patient typically sees their dentist for cleanings every six months. The aim of these visits is to remove dental plaque, a thin film of bacterial-laden particles that is the prime source for gum disease. These cleanings are meant to supplement a daily habit of brushing and flossing, which should remove the bulk of plaque that builds up throughout the day.
After gum disease treatment, though, you may need to have these cleanings more frequently, and of a more involved nature than the normal cleaning. For patients who've overcome advanced gum disease, that frequency could initially be every other week, every couple of months or every three months. This frequency may change depending on the status of your gum health.
Besides a thorough cleaning, a specialized periodontal maintenance visit may include other interventions. For example, your dentist may apply topical antibiotics or other anti-bacterial products to keep bacterial growth under control.
Protecting you from further gum infection isn't totally on your dentist's shoulders—you also have a role to play. You'll need to brush and floss your teeth thoroughly every day, along with using any other hygiene products prescribed or recommended by your dentist. Daily hygiene will help prevent the buildup of dental plaque and subsequent bacterial growth.
You'll also need to keep a watchful eye on your gums for any emerging signs of infection. If you begin to notice swelling, pain or bleeding, contact your dentist as soon as possible to initiate remedial treatment.
Gum disease treatment can bring your gums back to a reasonable state of good health. But that state could be reversed with a returning gum infection. Only vigilance practiced by both you and your dentist can stop that from happening.