It’s important to let your dentist know about all the
medications that you take. That’s because certain medications can influence
dental treatment decisions.
In the case of antiresorptive agents—medicines that help
strengthen bones—these medications have been associated with a rare but serious
condition called osteonecrosis (OSS-tee-oh-ne-KRO-sis) of the jaw (ONJ) that
can cause severe damage to the jawbone.
Some antiresorptive agents, such as Fosamax, Actonel,
Atelvia, Didronel and Boniva, are taken orally to help prevent or treat
osteoporosis (thinning of bone) and Paget's disease of the bone, a disorder that
involves abnormal bone destruction and regrowth, which can result in deformity.
Others antiresorptive agents, such as Boniva IV, Reclast or Prolia, are
administered by injection. Higher and more frequent dosing of these agents is
given as part of cancer therapy to reduce bone pain and hypercalcemia of
malignancy (abnormally high calcium levels in the blood) associated with
metastatic breast cancer, prostate cancer and multiple myeloma.
How do these medications affect dental treatment plans?
While osteonecrosis of the jaw can occur spontaneously, it
more commonly occurs after dental procedures that affect the bone or associated
tissues (for example, pulling a tooth). Be sure to tell your dentist if you are
taking antiresorptive agents so he or she can take that into account when
developing your treatment plan.
It’s not possible to say who will develop osteonecrosis and
who will not. Most people (more than 90 percent) diagnosed with ONJ associated
with these medications are patients with cancer who are receiving or have
received repeated high doses of antiresorptive agents through an infusion. The
other 10 percent (of people with ONJ) were receiving much lower doses of these
medications for treatment of osteoporosis. It may be beneficial for anyone who will
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 will keep your mouth healthy during treatment.
Continue regular dental visits
If you are taking antiresorptive agents for the treatment of
osteoporosis, you typically 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.
Ideally, 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 will be starting therapy with these drugs. Likewise,
let your physician know if you recently have had dental treatment.
Talk to your physician before ending medications
It is not generally recommended that patients stop taking
their osteoporosis medications. The risk of developing bone weakness and a
possible fracture is higher than those of developing osteonecrosis.
Talk to your physician before you stop taking any medication.
Symptoms of osteonecrosis of the jaw include, but are not
limited to:
pain, swelling, or infection of the gums or jaw
injured or recently treated gums that are not healing
loose teeth
numbness or a feeling of heaviness in the jaw
exposed bone
Contact your dentist, general physician or oncologist right
away if you develop any of these symptoms after dental treatment.
Call Omni Dental today to speak with one of our specialists about the latest ways of enhancing your smile and dental health. You can also go to our website: omnidentalgroup.com for more information.
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