Osteoporosis and Oral health
I recently learned about Osteoporosis in my dental hygiene Special Needs course. I ran across an article that can be beneficial to my career. This article is titled, "What the Dental Professional Must Know about Bisphosphonate Medications" and it was published in a Registered Dental Hygienist magazine.
The author starts by explaining how important it is for a dental professional to examine a patient's health history. It would be easy for a patient to mark no for everything on a health history form because a lot of patients do not realize the effects medications can have in the mouth. Also some patients may feel that some questions may be too personal, but that should not stop a dental hygienist from delving further into their health. It would be a great risk to the patient if a dental professional continued with dental treatment without full knowledge of their medication(s). One of the medications of concern are bisphosphonates. The author states that bisphosphonates can have devastating dental effects.
On average a dental office can see hundreds of patients a year who have osteoporosis or osteopenia and are taking some form of bisphosphonates. Osteoporosis is a bone disease that leads to an increased risk of fractures. While doctors are prescribing these medications by the millions, they come with great risk. The biggest risk with bisphosphonates is osteonecrosis of the jaw (ONJ) or death of the jawbone. The majority of reported cases of ONJ are patients with cancer who are treated with chemotherapy, bisphosphonates, and/or corticosteroids. These reported cases are associated with tooth extractions. The action of this medication is by inhibiting bone resorption. The bone density increases and the bone destroying action is slowed down. This action of bone destruction and rebuilding is of concern in the jaw bone because it does not allow bone healing. Patients who are being treated with bisphosphonates should avoid any invasive dental treatment if possible.
The author concludes her article stating, while bisphosphonates are helpful in prevention of factures in the hip, spine, and other skeletal areas, it is still ideal to have a collaboration with your physician and dental professional before any dental treatment is performed.
Personal reflection:
I learned from this article that there are things in medicine that are beneficial, but any risks need to be measured. I see the importance of treating patients as a whole because there may be systemic reactions with different types of medications. Therefore it should be priority to keep an open communication with our patients and always ask open-ended questions when reviewing a health history.
In my experience working at a Periodontal office and assisting in treatment of patients with osteoporosis/osteopenia, I did find this condition interesting. It is important for us to be aware of signs and symptoms and help make recommendations for prevention of this disease. It is also good to be aware of a patients overall health as we treatment plan. Some procedures may need to be done prior to beginning a medication regime.
Additional information:
http://www.mayoclinic.com/health/osteoporosis/DS00128
http://www.youtube.com/watch?v=NKVKNqIOnh0&feature=fvwrel
http://www.youtube.com/watch?v=HxsfkraUsRQ
Citation:
What the Dental Professional Must Know about Bisphosphonate Medications, RDH; Oct2006, Vol. 26 Issue 10, p78-114, 3p, Kathryn Gilliam, RDH, BA
The author starts by explaining how important it is for a dental professional to examine a patient's health history. It would be easy for a patient to mark no for everything on a health history form because a lot of patients do not realize the effects medications can have in the mouth. Also some patients may feel that some questions may be too personal, but that should not stop a dental hygienist from delving further into their health. It would be a great risk to the patient if a dental professional continued with dental treatment without full knowledge of their medication(s). One of the medications of concern are bisphosphonates. The author states that bisphosphonates can have devastating dental effects.
On average a dental office can see hundreds of patients a year who have osteoporosis or osteopenia and are taking some form of bisphosphonates. Osteoporosis is a bone disease that leads to an increased risk of fractures. While doctors are prescribing these medications by the millions, they come with great risk. The biggest risk with bisphosphonates is osteonecrosis of the jaw (ONJ) or death of the jawbone. The majority of reported cases of ONJ are patients with cancer who are treated with chemotherapy, bisphosphonates, and/or corticosteroids. These reported cases are associated with tooth extractions. The action of this medication is by inhibiting bone resorption. The bone density increases and the bone destroying action is slowed down. This action of bone destruction and rebuilding is of concern in the jaw bone because it does not allow bone healing. Patients who are being treated with bisphosphonates should avoid any invasive dental treatment if possible.
The author concludes her article stating, while bisphosphonates are helpful in prevention of factures in the hip, spine, and other skeletal areas, it is still ideal to have a collaboration with your physician and dental professional before any dental treatment is performed.
Personal reflection:
I learned from this article that there are things in medicine that are beneficial, but any risks need to be measured. I see the importance of treating patients as a whole because there may be systemic reactions with different types of medications. Therefore it should be priority to keep an open communication with our patients and always ask open-ended questions when reviewing a health history.
In my experience working at a Periodontal office and assisting in treatment of patients with osteoporosis/osteopenia, I did find this condition interesting. It is important for us to be aware of signs and symptoms and help make recommendations for prevention of this disease. It is also good to be aware of a patients overall health as we treatment plan. Some procedures may need to be done prior to beginning a medication regime.
Additional information:
http://www.mayoclinic.com/health/osteoporosis/DS00128
http://www.youtube.com/watch?v=NKVKNqIOnh0&feature=fvwrel
http://www.youtube.com/watch?v=HxsfkraUsRQ
Citation:
What the Dental Professional Must Know about Bisphosphonate Medications, RDH; Oct2006, Vol. 26 Issue 10, p78-114, 3p, Kathryn Gilliam, RDH, BA