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Osteoporosis - Oral Health Care Considerations

  • No contraindications for dental care, including dental implants.
  • Osteoporosis may be associated with a higher incidence of tooth loss.
  • Some studies have reported a correlation between osteoporotic bone loss and decreased cortical alveolar bone quality.
  • Antiresorptive agent-induced osteonecrosis of the jaw (ARONJ), also known as bisphosphonate- or medication-related osteonecrosis of the jaws (BRONJ) Camera icon, although extremely rare in patients with osteoporosis who take oral bisphosphonates, has been reported (see Bone HG, et al below).
  • Classifications and treatment strategies for provision of dental care have been proposed for patients with ARONJ.
  • If the patient is taking glucocorticosteroids for a chronic condition, be aware of possible adrenal suppression and bone pathology.
  • A possible association between osteoporosis and the development of arteriosclerosis has been reported.
  • Encourage patients to take vitamin D and calcium supplements, stop smoking, limit the use of alcohol, and start weight-bearing exercises.

What medications are you taking?#

One of the more controversial medications for osteoporosis is oral bisphosphonate. This medication has been associated with antiresorptive agent-induced osteonecrosis of the jaw (ARONJ), also known as bisphosphonate-related osteonecrosis of the jaws (BRONJ) Camera icon. Although the risk is extremely low – possibly around 5 cases per 10,000 person/year (see Bone HG, et al. below) – risk factors may include palatal tori, long-term use of the medication, glucocorticosteroid therapy, periodontal and dental diseases, older age, female gender, and traumatic dental procedures.

Classifications and treatment strategies have been developed to assess and provide dental care for patients with ARONJ.

Other nonbisphosphonate-type medications used to treat osteoporosis, including denosumab (Prolia), an injectable human monoclonal antibody, have also been associated with osteonecrosis of the jaws.


Medical Complexity Status - Osteoporosis#

OsteoporosisMCS1C
Anticipated
complication
Controlled/
stable
 HemostasisNone
 Microbial
 susceptibility
None
 Drugs/ drug
 interactions
Major
 Stress/traumaMajor

See Medical Complexity Status for more information.


Related Pages#

References/Websites#