Bisphosphonates are medications commonly used to prevent or treat osteoporosis (a thinning of the bones) or as part of cancer treatment. Some bisphosphonate medications (such as Fosamax, Actonel, Boniva) are taken orally (swallowed). Others, such as Aredia, Bonefos, Didronel or Zometa, are administered intravenously (injected into a vein).
In rare instances, some individuals receiving bisphosphonate therapy have developed Bisphosphonate-related osteonecrosis of the jaw (BRONJ), a serious condition that involves severe loss, or destruction, of the jawbone, and for which there is no known treatment. Necrosis refers to dead tissue, in this case bone, and the most common symptoms of BRONJ are areas of exposed bone in the upper or lower jaw that do not heal after more than 6 weeks. Most cases of osteonecrosis of the jaw associated with bisphosphonates have been diagnosed after dental procedures such as teeth extractions, however the condition can also occur spontaneously.
The actual incidence of BRONJ has not been accurately determined, but is reported from as low as 1 in 2,000 for certain oral medications to as high as 1 in 10 for those taking high bisphosphonate doses as part of cancer treatment. I have seen one case of BRONJ in my practice. It was after an extraction and the patient had not reported that he was taking bisphosphonates.
There are several important risk factors that can increase the possibility of developing BRONJ:
1. High doses
2. Continued use for more than 3 years
3. Corticosteroids being taken at the same time
4. Traumatic dental procedures such as teeth extractions
5. Alcohol or tobacco use
6. Diabetes
7. Poor oral hygiene
If you are considering the use of bisphosphonates for any reason, it is essential that you consult with your dentist and physician about the risks of BRONJ, and that you have any elective dental treatment completed prior to initiating therapy. If you are already using bisphosphonates you must inform your dentist so that he/she can help you make the best decisions about any future dental treatment.
Yours for excellent dental health,
Dr S
Sunday, April 17, 2011
Tuesday, April 5, 2011
HOW TO PREVENT ONE OF THE MOST COMMON SPORTS INJURIES
According to the American Dental Association, more than 200,000 oral injuries are prevented annually in this country by sports mouthguards. While this is an impressive preventative figure, unfortunately many teeth will still be damaged because failure to wear a proper sports mouthguard exposes an athlete to a 60 times greater chance of dental injury. In fact, dental trauma is the most common type of orofacial injury sustained during participation in sports.
I recently treated a patient in my office for the second injury to his front teeth
within two years. Different teeth were broken each time because he was not wearing a sports mouthguard. While we can repair most types of dental sports injuries, why not prevent them in the first place?
The child or athlete who loses a tooth (or teeth) in a sporting injury faces lifetime
dental rehabilitation costs of up to ten thousand dollars per tooth. The total rehabilitation costs for a single tooth lost in a sporting injury are likely to be
more than 50 times the preventative cost for a custom laminated, professional grade mouthguard.
There are significant differences between a custom fabricated sports mouthguard and the premade or boil and bite type mouthguards typically found in sporting goods stores. Boil and bite type mouthguards do not fit as accurately as custom fabricated types so they often are uncomfortable, frequently interfere with the athletes breathing and speaking ability, and do not provide adequate protection at the points where trauma is likely to occur. Properly designed and custom fabricated mouthguards are essential in the prevention of athletic oral/facial injuries. Check this link for more information on types of sports mouthguards:
http://www.sportsdentistry.com/mouthguards.html
If you have an athlete in your family involved in any type of contact sport, do not risk injury to their teeth by allowing them to play without a custom fitted mouthguard. Call your dentist today to make an appointment for this critically important service.
Yours for excellent dental health,
Dr S
I recently treated a patient in my office for the second injury to his front teeth
within two years. Different teeth were broken each time because he was not wearing a sports mouthguard. While we can repair most types of dental sports injuries, why not prevent them in the first place?
The child or athlete who loses a tooth (or teeth) in a sporting injury faces lifetime
dental rehabilitation costs of up to ten thousand dollars per tooth. The total rehabilitation costs for a single tooth lost in a sporting injury are likely to be
more than 50 times the preventative cost for a custom laminated, professional grade mouthguard.
There are significant differences between a custom fabricated sports mouthguard and the premade or boil and bite type mouthguards typically found in sporting goods stores. Boil and bite type mouthguards do not fit as accurately as custom fabricated types so they often are uncomfortable, frequently interfere with the athletes breathing and speaking ability, and do not provide adequate protection at the points where trauma is likely to occur. Properly designed and custom fabricated mouthguards are essential in the prevention of athletic oral/facial injuries. Check this link for more information on types of sports mouthguards:
http://www.sportsdentistry.com/mouthguards.html
If you have an athlete in your family involved in any type of contact sport, do not risk injury to their teeth by allowing them to play without a custom fitted mouthguard. Call your dentist today to make an appointment for this critically important service.
Yours for excellent dental health,
Dr S
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