At Thousand Oaks Family Dentistry, we take our patient’s medical histories very seriously. Every new patient appointment includes a questionnaire that covers hospitalizations, medications and trauma to the head and neck. While our records may seem tedious or unnecessary, they are vital to understanding and planning individualized treatment. For example, many dental-unrelated drugs will have side effects that manifest themselves in the oral cavity. One example of this are bisphosphonates, a type of drug commonly used to treat osteoporosis.
Osteoporosis is a medical condition that affects over 75 million people worldwide. Although many conditions trigger the onset of this disease, the result is always the same: decreased bone mass combined with increased porosity. While both men and women are affected, hormonal changes induced by menopause make the disease more prevalent in women. Bisphosphonates are a class of drug that counteract osteoporosis by down-regulating the cells that digest bone. These cells are normally utilized in balancing calcium and responding to fractures, but in osteoporosis they operate out of control. By preventing your body from absorbing bone, other cells can work towards repairing and thickening bone mass back to healthy levels.
While bisphosphonates can show great results in slowing or reversing the effects of osteoporosis, they also have a number of side effects. In the case of the oral cavity, their use can lead to increased risk of osteonecrosis of the jaw (ONJ). ONJ is a condition where the bones of the upper or lower jaw do not heal properly, typically following injury or invasive dental treatment such as extractions or gum grafts. Bisphosphonates are believed to interfere with wound healing, causing traumatized areas to become necrotic (dead tissue). The link between bisphosphonate use and ONJ is particularly strong in cancer patients who receive the drugs through an IV, but is also a concern in patients who take it orally.
Although the idea of developing ONJ may seem frightening, its risk is mitigated by effective planning and communication between physicians and dentists. This may include finishing all dental treatment prior to starting bisphosphonate therapy, or altering medications to minimize side effects. By working as a healthcare team, we can assure the best outcomes possible; even in complex diseases such as osteoporosis.
Bisphosphonates and ONJ highlight the absolute importance of our patients’ medical histories. Being thorough and honest with our office can only result in safer and more appropriate treatment. There are hundreds of commonly prescribed drugs that can cause serious changes to the teeth and oral cavity. If you would like to know more about drug interactions and the mouth, please call our office. We are always striving to keep our patients informed, happy and healthy!