Osteoporosis and dental treatment
By Rick Borquez, DDS

Breast cancer patients, individuals at risk for osteoporosis, and individuals undergoing certain types of bone cancer therapies often take drugs that contain bisphosphonates. These drugs may place patients at risk for developing osteonecrosis of the jaws (a rotting of the jaw bones), according to the May/June issue of General Dentistry.

Bisphosphonates are a family of drugs used to prevent and treat osteoporosis, multiple myeloma, Paget's disease (bone cancers), and bone metastasis from other cancers. These drugs can bond to bone surfaces and prevent osteoclasts (cells that breakdown bone) from doing their job.

Healthy bones constantly rebuild themselves. The jawbones have rapid cell turnover and can fail to heal properly in patients taking any of the bisphosphonate drugs.

Patients taking the drugs need to be aware of the possibility of complications from dental surgery or extractions. These drugs linger in the bone indefinitely and may upset the cell balance in how the jaws regenerate and remove unhealthy bone.

An example is a women who received bisphosphonate therapy intravenously to treat metastic cancer. She then developed osteonecrosis in her upper and lower jaws following tooth removal. This type of osteonecrosis has been occuring since the advent of these drugs.

At this time osteonecrosis as a result of bisphosphonate therapy has no treatment.

Patients who are taking these drugs should inform their dentist to prevent complications from dental surgical procedures.

It is strongly recommended that patients scheduled to receive

bisphosphonate therapy should visit a dentist or an oral surgeon so problematic teeth can be treated prior to the start of therapy.

Widespread use of bisphosphonates to prevent or treat early osteoporosis in rela

tively young women and the likelihood of long term use is a cause for concern.

How bisphosphonates interfere with healing after dental surgery is still unclear and further research will be needed. It is imperative that the public understands there is no present treatment or cure for this problem.

Borquez practices in Moor- park and is on the faculty at USC Dental School, specializing in cosmetic and orofacial pain (TMJ). He can be reached at (805) 529-1000 or online at www. borguezdental.com