Osteoporosis…What Is It?
Osteoporosis is a disease of bones that leads to a decreased density of bone and subsequent increase in risk of fracture. Inosteoporosis, the bone mineral density (BMD) is
reduced, bone micro architecture deteriorates, and the amount and variety of proteins in bone are altered.
Osteoporosis is a bone weakening disease that has affected millions of people worldwide. TheNational Osteoporosis Foundation estimates that osteoporosis is a health threat for about 44 million people in the United States alone. The disease is far more prevalent in women than men. According to The National Osteoporosis Foundation, women are four times more likely than men to develop osteoporosis.
Because of these numbers, it is important for women to maintain a healthy lifestyle and diet even in their youth. Exercise and a proper diet for young women can help build strong bone mass for the future to avoid issues (like osteoporosis) later in life. There are recent studies showing that women who drink wine in moderation tend to have higher bone density than those who abstain from alcohol.
Medications Used for Osteoporosis and their Dental Link
Certain osteoporosis medications (also called bisphosphonates) have possibly been linked to osteonecrosis
(or “death of bone”) of the jaw. Osteonecrosis is bone death caused by poor blood supply to the area. It is most common in the hip and shoulder, but can affect other large joints such as knee, elbow, wrist, ankle, and jaw. Osteonecrosis is a rare and serious disease that can causes destruction of the jawbone. a condition marked by pain, swelling, infection and exposed bone. The majority of cases of osteonecrosis of the jaw involve people with cancer who have been treated with intravenous bisphosphonates. A number of cases of osteonecrosis of the jaw have been reported in people taking oral bisphosphonates for osteoporosis. These have been primarily associated with active dental disease or a recent dental procedure, such as atooth extraction.
Osteonecrosis can occur at any age range and can affect a wide range of ethnicity’s. Osteoporosis is considered a very serious disease and is responsible for well over 1.5 million bone fractures per year.
According to the American Dental Association (ADA), osteonecrosis of the jaw linked with osteoporosis medications has mainly been seen in cancer patients who are receiving the bisphosphonates intravenously. In fact, 94% of the cases reported are linked to intravenously-administered bisphosphonates while only 6% are linked with the oral medications.
How Do Bisphosphonates Cause These Bone Issues?
Bisphosphonates are very effective in slowing down the breakdown of bone by targeting the cells which breakdown bone (osteoclasts). An unfortunate side effect is, that they also slow down the bone cells which create new bone (osteoblasts). In areas of the body where the bones do not change much after development, (leg, hip, arm bones), this is not very disruptive. In areas such as the jaw, where bone is constantly reforming and reshaping, the lack of strong bone rebuilding cells is inhibitive to forming new bone after an extraction.



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Hi MPerrone Welcome! Thanks so much for including this information on BIONJ!
I was wondering if you recommend a serum CTx test if your patients have taken one of the Bisphosphonates (BPs) for an extended period of time?
I took Actonel for about 1.5 years and also have Von Willebrand type 1, and my dentist/oral surgeon won't do extractions unless I receive DDAVP (desomopressin) infusion prior to the procedure. Since they are very pro-active on possible healing complications and my bleeding time, would you also suggest the c-telopeptide test to see what the score is prior to an extraction, due to Actonel exposure? I also have periodontitist. I inherited this, and have had gum surgery and antibiotic placement in deep pockets. I've never had any trouble with a non-healing extraction, but the oral surgeon is still very cautious, but doesn't order the c-telopeptide test.
Thanks again!