Osteoporosis and oral health

It’s important to let us 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 anti-resorptive 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 mention if you are taking anti-resorptive agents, so we 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 per cent) 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 per cent (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 visit us before beginning treatment or shortly after. This way, we can ensure that you have good oral health going into treatment and develop a plan that will keep your mouth healthy during treatment.

Dr Keith John

email: drkeithjohn@gmail.com

Clinic: Heritage Dental

Tel: 784-456-2220

Cell: 784-526-0752