Osteoporosis and Oral Health: What You Need to Know
Osteoporosis is a condition that weakens bones and makes them more prone to fracture, affecting about 10 million Americans. This condition can affect any part of the body, including the jawbone that supports the teeth. This is particularly concerning when considering procedures like dental implants, whose success relies on the implant fusing to healthy bone—a process called osseointegration.
Living bone tissue is constantly being remodeled by two processes:
- Resorption: The body removes and breaks down old, damaged bone.
- Bone Formation: Removed material is replaced by new, healthy bone.
Osteoporosis tips this balance toward resorption, weakening the bone structure.
Bisphosphonates and the Jawbone
A class of drugs called bisphosphonates (e.g., Fosamax, Boniva, Reclast, Prolia) are used to treat osteoporosis by inhibiting resorption. While highly effective, these medications sometimes have a different effect on the jawbone. In rare cases, long-term bisphosphonate users experience osteonecrosis of the jaw (ONJ), where isolated areas of jawbone lose vitality and die.
Considerations for Dental Procedures
- Over 90 percent of bisphosphonate-associated ONJ cases occurred in people receiving high doses intravenously, often for cancer treatment. Only a small percentage of those taking the drug orally are likely to develop this condition.
- If you are starting high-dose therapy, it is ideal to resolve any oral disease with a dental exam before beginning the medication. It’s best to avoid invasive dental treatments while receiving high-dose medication if possible.
- Most people who take oral bisphosphonates for osteoporosis won’t have to postpone or avoid dental procedures, as their risk of ONJ is low.
- For dental implant placement, the decision is made on an individual basis after a thorough examination of the jawbone’s quality. The presence of osteoporosis may influence the type of implants used and the healing time needed.
It is vital to keep us informed about any medical conditions you have and any drugs you may be taking before considering dental procedures.
Preventing Osteoporosis
You can help prevent osteoporosis by:
- Getting enough calcium and vitamin D.
- Decreasing your caffeine and alcohol intake, and quitting smoking.
- Engaging in weight-bearing exercise (like walking, jogging, or weight training).
- Maintaining regular dental visits, as we encourage both your oral and overall health.