Osteoporosis is a disease of the bones that leads to a lowered density of bone and an eventual increase in risk of bone fractures. In osteoporosis, the bone mineral density (BMD) is lowered, bone micro architecture breaks down, and the amount and variety of proteins in the bone are changed.
Osteoporosis is a disease that causes the bones to weaken. Osteoporosis has affected millions of people all over the world.. The National Osteoporosis Foundation has estimated that osteoporosis is a health risk to about 45 million people in America alone. Osteoporosis is much more common in women than men. According to The National Osteoporosis Foundation, women are 4x more likely than men to develop osteoporosis.
Because of the increased risk for women, it is important for women to keep a healthy lifestyle and diet even when they are younger. Regular physical activity and a proper diet for younger females can help build adequate bone mass density for the future to avoid health problems (like osteoporosis) as they get older. There is recent research showing that women who consume wine in moderation tend to have higher bone density than women who do not drink alcohol.
Drugs Used for Osteoporosis and their link to your Oral Health
Certain medications prescribed for osteoporosis (also called bisphosphonates) have possibly been linked to osteonecrosis (death of bone) of the jawbones. Osteonecrosis is bone death caused by very poor supply of blood to the affected area. The hip and shoulder are the most common areas affected, but osteonecrosis can also affect other large joints like the knee, elbow, wrist, ankle, and jaw. Osteonecrosis is a rare and serious disease that can cause destruction of the jawbone. a condition marked by pain, swelling, infection and exposed bone. Most of the cases of osteonecrosis of the jawbones involve patients with cancer. Especially those who have been treated with intravenous(IV) bisphosphonates. A number of cases of osteonecrosis of the jawbones have been reported in patients taking oral bisphosphonates for osteoporosis. These have been primarily associated with active dental disease or a recent dental procedure, such as a tooth extraction.
Osteonecrosis occurs at any age range and can affect a wide range of ethnic backgrounds. Osteoporosis is considered a very serious disease and is responsible for well over 1.5 million fractures of the bones every 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, over 90% of the cases reported are linked to intravenously-administered bisphosphonates while only 6% are linked with the orally administered 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.
Common Bisphosphonates administered for Treatment of Osteoporosis
Causes of Osteonecrosis?
Osteonecrosis occurs when part of the bone does not get sufficient blood and eventually dies. After a period of time the bone can collapse under its own weight. If this condition is not treated, the joint will deteriorate and this will become severe arthritis.
Osteonecrosis can be caused by disease, or a severe trauma, that affects the blood supply directly to the bone. Many times, no trauma or disease is present. This is called "idiopathic osteonecrosis" (which means it occurs with no known cause).
Direct Causes of Osteonecrosis:
-Long term use of steroids.
-Abuse of alcohol.
-Sickle Cell Disease.
-Gaucher Disease. This is a genetic disease in which a fatty substance (lipid) accumulates in cells and certain organs.
-Decompression sickness from a lot of deep sea diving
-Break, Dislocation, fractures around a joint.
Diseases Associated with Osteonecrosis:
-Loosening of teeth.
-Pain in the Jawbone.
-Swelling in the area affected.
-Bone becoming exposed.
Women must remember that osteonecrosis of the jaw bone from bisphosphonate medication administration is quite rare. The drugs being used to counteract osteoporosis have proven benefits to counteract a very serious disease and reduce bone loss. If you are taking any of the bisphosphonate drugs for osteoporosis call your physician before stopping them. It is also very important to inform your dentist that you are taking such medications so they can have it in their medical history in case something arises during your course of treatment.
Maintain a proper diet, exercise regimen, along with regular visits to your dentist and physician to keep your osteoporosis under control.
By Marielaina Perrone DDS
Cosmetic Dentist Henderson Nevada
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