Posts for: November, 2014
If you have osteoporosis, one of the drugs you may be taking is alendronate, more commonly known by the brand name Fosamax®. Alendronate is a member of the bisphosphonate drug family, which inhibit bone resorption (the loss of bone mass). While an effective treatment of osteoporosis, alendronate may cause an opposite side effect in other areas of the body, the inhibition of new bone growth. This effect on the jaw in particular could result in an adverse reaction after dental surgery.
The main concern is a condition called osteonecrosis, or literally “bone death.” Bone tissue normally goes through a cycle of resorption (the dissolving of bone tissue) and new growth to replace the cells that have been lost through resorption. Osteonecrosis disrupts the growth phase so that the bone doesn’t recover properly after resorption. This results in the bone becoming weaker and less dense.
There have been a number of cases of increased osteonecrosis in patients on alendronate after experiencing trauma to the mouth. This includes dental surgery, particularly tooth extractions. In addition, patients with certain risk factors like diabetes, tobacco use or corticosteroid therapy appear more vulnerable to osteonecrosis.
Although the risk of osteonecrosis after dental surgery is small, many dentists recommend stopping the use of alendronate for three months before the procedure if you’ve been taking the drug for more than three years. This recommendation is based on a number of studies that seem to indicate three or more years of bisphosphonates therapy makes patients especially vulnerable to osteonecrosis. These studies also indicate stopping the therapy for three months significantly reduces the risk of developing the condition.
There’s still much to be learned about this link between alendronate therapy and dental health. It’s a good idea, then, to let us know what medications you’re taking (especially bisphosphonates) whenever you visit us for an exam. Knowing all your medications will help us develop the safest and most effective treatment plan for your dental care.
If you would like more information on bisphosphonates and their effect on oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fosamax and Surgery.”
Sometimes, we all need a bit of prompting to do what's good for us. When Serena Girardi, the 10-year-old daughter of New York Yankees manager Joe Girardi, needed to have orthodontic treatment, she was a little nervous. To help lessen her anxiety, Girardi, then 45 years old, made a deal: if she got braces, then he would too.
“What I didn't realize,” said Girardi in an interview with ESPN, “is that she only had to get four on her front teeth and I got the full mouthful.”
But that didn't stop the baseball great from keeping up his end of the bargain. In a separate deal with his son Dante, who also needed braces, Girardi agreed to wear blue rubber bands. “It's a good look,” he said. What will he do if his third child needs braces? Stay tuned...
Whether it starts as a bargain with your kids or as a promise to yourself, orthodontic treatment can offer real benefits at any age. In fact, about one out of five orthodontic patients today is an adult. Studies have shown that up to three-quarters of all adults have some form of orthodontic problem, like drifting or crowding of teeth. And having a great-looking smile not only improves self-confidence, but can also boost an adult's social life, and even enhance his or her career opportunities.
If you or your child may need braces, but you're put off by the dreary metal hardware you remember from back in the day, take heart! Plenty has changed in the field of orthodontics since you were a teenager — and it's not just the color of the rubber bands.
In many cases, clear or colorless ceramic braces can be used instead of metal ones. These stain-resistant orthodontic appliances blend in well with your own teeth, making them much less evident. It may be possible for them to be placed on the lingual (tongue) side of the teeth, where they're even less visible.
Clear aligners offer an alternative to braces that's appropriate for some people. Aligners are a series of precision-made “trays” composed of polyurethane plastic. Worn 20-22 hours per day for a period of months, these appliances gradually move teeth into an improved position. Besides being virtually invisible, another advantage of these trays is that they may be removed for eating and for important occasions. Once recommended only for adults, they have recently become available to teenagers as well.
What's the best way to find out whether you or someone in your family could benefit from orthodontics, and which treatment option best suits your individual needs? Come in to our office for a consultation! After a thorough examination, we would be happy to recommend the most appropriate treatment methods for your particular situation.
If you have questions about orthodontic treatment, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Orthodontics For The Older Adult” and “Clear Aligners for Teenagers.”