Years ago, we in the oral surgery and dental professions were very worried about Fosamax and the related drugs patients used for osteoporosis/osteopenia therapy. We were concerned that there would be a significantly high risk of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in patients who used bisphosphonates for the management of osteoporosis or osteopenia.
Studies were conducted over the past several years that shows those who take intravenous bisphosphonates are more likely to have a risk of BRONJ (0.8%-20%) than those who take oral bisphosphonates (around 0.1%). Studies continue to be presented showing the reduced incidence of BRONJ. Regardless of the improving outlook for those patients, there are some dental guidelines that patients need to follow:
1) maintain regular dental examinations/checkups, preferably 2-3x year to prevent any dental infection from evolving into a need for oral surgery.
2) regular daily self-care is essential, including use of an electric toothbrush, oral antimicrobial rinse, and interdental cleaning devices (floss, waterpik, etc)
3) Non-surgical dental solutions are always preferred when managing patients with a history of bisphosphonate use.
4) Denture wearers who use bisphosphonates are at risk for soft tissue perforations or tears that can lead to BRONJ. Regular oral exams and assessment of the dentures are best.
Patients who undergo bisphosphonate therapy may need surgical treatment. There is a specific protocol that we provide for patients who require oral surgery to reduce the risk of BRONJ.
Call our office and let us help you reduce your risk for BRONJ.
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