Osteoporosis is a major health condition affecting millions of people, mostly women over 50. The disease weakens bone strength to the point that a minor fall or even coughing can result in broken bones. And, in an effort to treat it, some patients might find themselves at higher risk of complications during invasive dental procedures.
Over the years a number of drugs have been used to slow the disease’s progression and help the bone resist fracturing. Two of the most common kinds are bisphosphonates (Fosamax) and RANKL inhibitors (Prolia). They work by eliminating certain bone cells called osteoclasts, which normally break down and eliminate older bone cells to make way for newer cells created by osteoblasts.
By reducing the osteoclast cells, older bone cells live longer, which can reduce the weakening of the bone short-term. But these older cells, which normally wouldn’t survive as long, tend to become brittle and fragile after a few years of taking these drugs.
This may even cause the bone itself to begin dying, a relatively rare condition called osteonecrosis. Besides the femur in the leg, the bone most susceptible to osteonecrosis is the jawbone. This could create complications during oral procedures like jaw surgery or tooth extractions.
For this reason, doctors recommend reevaluating the need for these types of medications after 3-5 years. Dentists further recommend, in conjunction with the physician treating osteoporosis, that a patient take a “drug holiday” from either of these two medications for several months before and after any planned oral surgery or invasive dental procedure.
If you have osteoporosis, you may also want to consider alternatives to bisphosphonates and RANKL inhibitors. New drugs like raloxifene (which may also decrease the risk of breast cancer) and teriparatide work differently than the two more common drugs and may avoid their side effects. Taking supplements of Vitamin D and calcium may also improve bone health. If your physician still recommends bisphosphonates, you might discuss newer versions of the drugs that pose less risk of osteonecrosis.
Managing osteoporosis is often a balancing act between alleviating symptoms of the disease and protecting other aspects of your health. Finding that balance may help you avoid future problems, especially to your dental health.
If you would like more information on osteoporosis and dental care, 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 “Osteoporosis Drugs & Dental Treatment.”
Is having good oral hygiene important to kissing? Who's better to answer that question than Vivica A. Fox? Among her other achievements, the versatile actress won the “Best Kiss” honor at the MTV Movie Awards, for a memorable scene with Will Smith in the 1996 blockbuster Independence Day. When Dear Doctor magazine asked her, Ms. Fox said that proper oral hygiene was indeed essential. Actually, she said:
"Ooooh, yes, yes, yes, Honey, 'cause Baby, if you kiss somebody with a dragon mouth, my God, it's the worst experience ever as an actor to try to act like you enjoy it!"
And even if you're not on stage, it's no fun to kiss someone whose oral hygiene isn't what it should be. So what's the best way to step up your game? Here's how Vivica does it:
“I visit my dentist every three months and get my teeth cleaned, I floss, I brush, I just spent two hundred bucks on an electronic toothbrush — I'm into dental hygiene for sure.”
Well, we might add that you don't need to spend tons of money on a toothbrush — after all, it's not the brush that keeps your mouth healthy, but the hand that holds it. And not everyone needs to come in as often every three months. But her tips are generally right on.
For proper at-home oral care, nothing beats brushing twice a day for two minutes each time, and flossing once a day. Brushing removes the sticky, bacteria-laden plaque that clings to your teeth and causes tooth decay and gum disease — not to mention malodorous breath. Don't forget to brush your tongue as well — it can also harbor those bad-breath bacteria.
While brushing is effective, it can't reach the tiny spaces in between teeth and under gums where plaque bacteria can hide. But floss can: That's what makes it so important to getting your mouth really clean.
Finally, regular professional checkups and cleanings are an essential part of good oral hygiene. Why? Because even the most dutiful brushing and flossing can't remove the hardened coating called tartar that eventually forms on tooth surfaces. Only a trained health care provider with the right dental tools can! And when you come in for a routine office visit, you'll also get a thorough checkup that can detect tooth decay, gum disease, and other threats to your oral health.
Bad breath isn't just a turn-off for kissing — It can indicate a possible problem in your mouth. So listen to what award-winning kisser Vivica Fox says: Paying attention to your oral hygiene can really pay off! For more information, contact us or schedule an appointment for a consultation. You can read the entire interview with Vivica A. Fox in Dear Doctor's latest issue.
Dental amalgam—also known as “silver fillings”—has been used for nearly a hundred years to treat cavities. There are several reasons why this mixture of metals has been the go-to material among dentists: Malleable when first applied, dental amalgam sets up into a durable dental filling that can take years of biting forces. What’s more, it’s stable and compatible with living tissue.
But there’s been growing concern in recent years about the safety of dental amalgam, with even some wondering if they should have existing fillings replaced. The reason: liquid mercury.
Mercury makes up a good portion of dental amalgam’s base mixture, to which other metals like silver, tin or copper are added to it in powder form. This forms a putty that can be easily worked into a prepared cavity. And despite the heightened awareness of the metal’s toxicity to humans, it’s still used in dental amalgam.
The reason why is that there are various forms of mercury and not all are toxic. The form making headlines is known as methylmercury, a compound created when mercury from the environment fuses with organic molecules. The compound builds up in the living tissues of animals, particularly large ocean fish, which have accumulated high concentrations passed up through their food chain.
That’s not what’s used in dental amalgam. Dentists instead use a non-toxic, elemental form of mercury that when set up becomes locked within the amalgam and cannot leach out. Based on various studies, treating cavities with it poses no health risks to humans.
This also means there’s no medical reason for having an existing silver fillings removed. Doing so, though, could cause more harm than good because it could further weaken the remaining tooth structure.
The most viable reason for not getting a dental amalgam filling is cosmetic: The metallic appearance of amalgam could detract from your smile. There are newer, more life-like filling options available. Your dentist, though, may still recommend dental amalgam for its strength and compatibility, especially for back teeth. It’s entirely safe to accept this recommendation.
When you first received your removable dentures the fit was firm and comfortable. Lately, though, they’ve become loose, making it difficult to eat or speak without slippage.
The problem may not be with your denture, but with bone loss. Human bone goes through a natural cycle of dissolving (known as resorption) and new growth to take the lost bone’s place. The jawbone receives further stimulation to grow from the forces generated by natural teeth when we bite or chew.
When natural teeth are missing, however, the jawbone lacks this stimulation, which over time results in bone loss and gum tissue shrinkage. Traditional dentures can’t transmit this stimulating force to the jawbone either, so the bone and gum structure under a denture will also shrink. This results in a looser fit for the denture.
The simplest option to correct a loose-fitting denture (especially if it’s the first occurrence) is to reline the dentures with additional material to re-form the fit to the new conditions in the mouth. A permanent relining will require sending your dentures to a dental laboratory to apply the new material based on a mold of your current anatomy beneath the denture.
If, however, your dentures have already undergone a few relinings, or after examining your gums we determine a relining won’t provide the fit and stability needed, then it may be time for a new denture. Although this is more costly than a relining, a new appliance could provide a more accurate fit to the current contours in your mouth.
The latter option may also give you a chance to benefit from advancements in denture technology or materials since you received your current denture. One such advancement is a removable denture that’s supported by implants. It’s possible to achieve this new supporting foundation for the denture with as few as two strategically-placed implants in the lower jaw.
If you’ve begun to notice denture looseness, be sure to make an appointment for an examination. From there, we can advise you on what will work best in your particular case.
If you would like more information on your options regarding removable dentures, 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 “Loose Dentures.”
If you’re considering different options for tooth replacement, dental implants are likely high on your list. Implants have a proven reputation for both durability and life-like appearance that can restore mouth function and revitalize your smile.
There is one aspect concerning implants, however, which gives people pause — the surgical procedure required to place the implants in the jawbone. If you’re leery about undergoing this procedure we can put your mind at ease — for most patients implant surgery is a minor, pain-free process with little discomfort afterward.
While there are variations in style, implants generally have two major components: a titanium post that’s implanted into the jawbone and a permanent life-like crown that’s affixed 6 to 12 weeks after implant surgery. Titanium is the metal of choice because of its affinity with bone cells; over time bone will grow to and attach itself around the implant, a process known as osseo-integration. The metal post is normally spiral in shape, allowing it more surface area for bone to adhere to.
In the beginning of the procedure we administer local anesthesia to fully numb the area before proceeding. After accessing the bone through tiny incisions in the gum tissue, we create a small channel in the exposed bone. A surgical guide may be used to prepare the precise location for the implant with a series of drilling sequences that increases the channel until it matches the implant size. While this takes place, you should only feel a mild vibration and a little pressure from the drill.
The implants are then removed from their sterile packaging and placed immediately into the prepared site. The gum tissues are then sutured into place with self-absorbing sutures. Most people have only mild discomfort after the surgery that can be managed with a prescription-strength non-steroidal anti-inflammatory drug like ibuprofen. We may also prescribe antibiotics and other care instructions to ensure successful gum tissue healing.
With proper planning and precise implant placement by skilled hands, implant surgery is an easy and uneventful procedure. And, with your new crowns in place, your new, beautiful smile will make the experience a distant memory.
If you would like more information on dental implants, 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 “Dental Implant Surgery.”
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