Osteoporosis and osteonecrosis are serious bone conditions that can have significant implications for oral health. Awareness and timely intervention are critical for maintaining a healthy smile and preventing complications.
In this issue, we will discuss the dental implications of these common conditions.
Osteoporosis: A Silent Threat to Bone Health
Osteoporosis is a systemic condition characterized by decreased bone density and increased fragility, making bones more prone to fractures. While it primarily affects the hips, spine, and wrists, the condition also impacts the jawbone—an essential structure supporting the teeth. As the jawbone weakens, it can lead to tooth loss, ill-fitting dentures, and challenges in performing dental implants or other restorative procedures.
Women, particularly postmenopausal women, are at a higher risk of osteoporosis due to hormonal changes that accelerate bone loss. Men, too, can develop osteoporosis, especially if they have underlying conditions, use certain medications like corticosteroids, or lead a sedentary lifestyle.
Osteonecrosis: An Increasingly Common but Severe Condition
Osteonecrosis of the jaw (ONJ) is a condition in which the jawbone fails to heal after minor trauma or infection, leading to bone exposure and eventual necrosis (death of bone tissue). It is most commonly associated with the use of certain medications, such as bisphosphonates- risedronate (Actonel), alendronate (Fosamax), ibandronate (Boniva), zoledronic acid (Reclast), and pamidronate (Aredia) and denosumab injections, which are prescribed to manage osteoporosis and other bone disorders. Other risk factors for ONJ include radiation therapy to the head and neck, invasive dental procedures like tooth extractions, and underlying health conditions such as diabetes or cancer.
ONJ often presents with symptoms such as pain, swelling, infection, and exposed bone in the oral cavity. Early detection and management are crucial to prevent severe complications.
Dental Implications of Osteoporosis and Osteonecrosis
The health of the jawbone is intricately linked to overall oral health. Osteoporosis can result in:
- Tooth Loss: Reduced jawbone density weakens the support for teeth, increasing the likelihood of tooth mobility and eventual loss.
- Challenges in Dental Implants: A strong and healthy jawbone is critical for the success of dental implants. Osteoporosis can compromise the bone’s ability to integrate with the implant, reducing the success rate.
- Periodontal Disease: Research suggests that osteoporosis may exacerbate periodontal (gum) disease by weakening the supporting bone structure.
Osteonecrosis, poses unique challenges in dental care:
- Complications in Dental Procedures: Surgical interventions such as extractions or implants can exacerbate ONJ, necessitating meticulous planning and coordination with medical professionals.
- Increased Risk of Infection: The exposed necrotic bone provides a pathway for bacterial invasion, leading to infections that are difficult to manage.
Tips for Protecting Oral Health
- Inform Your Dentist: If you have osteoporosis or are taking medications such as bisphosphonates, notify your dentist. This helps in planning safe and effective treatments.
- Practice Good Oral Hygiene: Brushing twice daily, flossing, and regular dental visits are essential to prevent infections and maintain gum health.
- Lifestyle Changes: Adequate calcium and vitamin D intake, regular exercise, and avoiding smoking or excessive alcohol consumption can strengthen bones and support oral health.
- Seek Prompt Care: If you notice symptoms like loose teeth, jaw pain, or exposed bone, consult your dentist immediately.
Understanding the connection between bone health and oral health is vital for overall well-being. By taking preventive measures and working closely with your dentist and healthcare provider, you can minimize risks and maintain a healthy smile for years to come.
Dr. Kendal V. O. Major is Founder and CEO of Center for Specialized Dentistry which is a comprehensive family dental practice operating in Nassau and Freeport. He is the first Bahamian Specialist in gum diseases and dental implants since 1989. He also is a certified Fast braces provider. His practice is located at 89 Collins Avenue, Nassau at (242)325-5165 or [email protected]
Osteonecrosis of the jaws- area infected from lack of healing
Left side of Panorex shows evidence of necrosis of the jaw associated with infected tooth
