First things first: What is Osteoporosis?
Not to be confused with Osteoarthritis, Osteoporosis is a disease of the bones whereas Osteoarthritis is a disease of the joints and surrounding tissues.
Our bones are made up of minerals, proteins and other substances. A certain amount of these minerals, proteins, etc. are needed in order for one to have healthy and strong bones.
A reduction in the level of these substances results in low bone mass and a low bone mineral density (BMD). The microstructure of the bones deteriorates which leads to an increase in the risk of the bones fracturing.
A certain group of medications are used to treat Osteoporosis. In dentistry it is important that we know whether a patient is taking these medications before their treatment begins.
These are the Bisphosphonate drugs. They include Boniva, Fosamax, Actonel, Zometa, Reclast, Aredia and Alendro.
The bones in your body, including the jaw bone are in a constant state of remodeling.
The definition of bone remodeling: Cells in the bone lay down new bone and remove older bone at the same time. This is a normal metabolic process that occurs within the bones of your body.
Bisphosphonate drugs disrupt the normal state of bone metabolism. In addition, they also decrease the blood supply to the bone. As blood flow is needed for normal healing, this decrease in blood flow can result in Osteonecrosis or areas of ‘dead bone’.
With respect to the jaw bone, this used to be called O.N.J or Osteonecrosis of the Jaw. Now it is known as A.R.O.N.J or Anti-Resorptive Drug Associated Necrosis of the jaw.
It is important for your dentist to know if you are taking any kind of Bisphosphonate drug, because if dental surgery is needed, then the healing of the bone may be compromised.
This includes procedures such as extractions, dental implants or dentoalveolar surgery.
A major consideration as to whether or not a patient can be treated is if the drug is administered orally or intravenously.
In the next blog we will discuss how the route of entry of the drug can affect the kind of dental treatment that can be performed.
Yours in good dental health and wellness,
Dr. Robert Axelrad, Brampton Dentist
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