Osteoporosis Medications
There are many people aged 50 years or older with osteoporosis. Due to related fractures, osteoporosis is responsible for considerable morbidity and mortality.
Antiresorptive agents, like bisphosphonates, often are used to treat osteoporosis, lowering the risk of related fractures. In rare cases, use of antiresorptive agents has been associated with osteonecrosis of the jaw. However, the risk of developing osteonecrosis of the jaw (ARONJ) is low.
Although osteonecrosis can occur spontaneously, more commonly osteonecrosis has been reported after dental treatments — most often invasive procedures like tooth extractions — in patients treated with antiresorptive agents.
While it is not possible to identify who will develop osteonecrosis and who will not, research suggests the following risk factors exist:
- Age older than 65 years;
- Periodontitis (gum disease)
- Prolonged use of antiresorptive agents (more than two years)
- Smoking
- Denture wearing
- Diabetes
DENTAL MANAGEMENT
IF YOU ARE ON THESE MEDICATIONS, IT IS CRITICAL THAT YOU MAINTAIN REALLY GOOD ORAL HEALTH. THE IDEAL SCENARIO IS TO HAVE A COMPLETE EXAMINATION AND HAVE ALL OUTSTANDING ISSUES DEALT WITH BEFORE YOU START THE MEDICATION.
All patients should receive routine dental examinations. Patients who are prescribed antiresorptive agents and are not receiving regular dental care would likely benefit from a comprehensive oral examination before or early in their treatment.
While neither the physician nor the dentist can eliminate the possibility of osteonecrosis development, regular dental visits and maintaining excellent oral hygiene are essential parts of risk management.