When making the decision to take a medication, it is important for the patient and physician to understand the risks and rewards of a particular drug, because all drugs have side effects.
Some drugs that have side effects with implications for dental health are bisphosphonates. Bisphosphonates have names that many of you will recognize – Fosamax, Boniva, Actonel, and Reclast are popular drugs in this class.
Bisphosphonates are used to treat osteopenia (lower than normal bone density), osteoporosis (brittle and weak bones), and some cancers. They are antiresorptive medications used to stop or slow the natural process of bone loss, which occurs as we age. This class of drugs is a very important tool for the aging population (think of all the baby boomers!) in our country. These drugs slow bone breakdown and reduce the risks of fractures.
Before beginning bisphosphonate therapy it is a good idea to see your dentist and have a thorough check-up. It is also wise to complete any necessary dental work, if possible, before beginning this medication regimen.
The reason for this precaution is that, in rare instances, bisphosphonates can cause osteonecrosis of the jaw. This condition results in problems with bone healing, often leaving open wounds susceptible to serious infections. This is particularly a concern after dental surgery if a patient has this problem.
Although this condition occurs more frequently with patients who are taking larger doses, usually for cancer treatment, it is important for the dentist to be aware of any patient who is having dental work while taking these medications.
A good rule of thumb is this: always tell your dentist if you are having bisphosphonate therapy and always tell your physician if you need dental work while on these medications. This side effect (osteonecrosis of the jaw) is rare, but knowledge is power. With the proper information, your dentist and your physician can work together to avoid serious complications.
