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Osteoporosis and your Dentist (part 2)

There are many commercials right now on tv by lawyers warning people about bisphosphonates. Lots of people are worried, but you shouldn’t be. The lawyers are trying to say that bisphosphonates (this is a class of medications that includes: Fosamax(alendronate), Actonel, Boniva & is used in treating osteoporosis) can cause osteonecrosis after a dental procedure. This is not true. In fact, the incidence for oral Fosamax, Actonel, or Boniva causing osteonecrosis occurs less than 1 case per 100,000 patients per year. About 94% of the cases of osteonecrosis are in cancer patient who are receiving intravenous (not oral) Zometa or Aredia. These specific IV medications are usually used in treating cancers that have spread to the bone.

Osteonecrosis of the jaw is bone damage that is extremely rare and occurs due to bone injury. The bone does not heal properly after the injury (for example a tooth extraction), and causes severe pain and swelling, then bone death. It is thought that bisphosphonates may increase the incidence of osteonecrosis because they might slow healing and suppress bone turnover after a dental procedure. Clinical trials do not support this with oral bisphosphonates only intravenous. Dr. Jason McCargar, DMD said according to the ADA it is advised that patients notify their dentist if they are taking these medications. He recommends that patients have routine dental exams before starting therapy and again within 3 months after starting therapy, then every 6 months thereafter. Dr. McCargar also stresses that good dental hygiene can decrease the risk of osteonecrosis. He says that brushing and flossing your teeth at least once per day (preferrably twice) can keep your gums and teeth healthy and prevent many dental procedures such as extractions. Dr. McCargar also says that bisphosphonates are very safe medications and the benefits of using them far outweigh the risks. Bisphosphonates can help to make your bones stronger and prevent them from breaking.