Meds For Osteoporosis Can Cause Severe Damage To Jaw Bone

Posted on Mar 06, 2017 by William J. Claiborne, DDS MS

It seems every time I turn on the television, I see a commercial touting some new ‘wonder drug.’ Typically, I’m blown away when the list of potential side effects are mentioned. Apparently, many of these drugs solve one problem only to create ten more. This brings to mind a concern for those who are taking drugs for osteoporosis.

As we age, so does the structure of our bones. After the age of 40, adults begin to lose bone as the body’s ability to build up bone tissues decreases. Adults who have the most risk for bone loss include:

• Females
• Being over the age of 65
• Women who are going through menopause or are post-menopausal
• Being small in statue or having low body weight
• Using tobacco and excessive alcohol use
• Having a family history of fractures associated with osteoporosis
• Seventy percent of people with osteoporosis are women. Because men lose calcium at a slower rate than women, their risk is lower. However, older men are also at risk for osteoporosis.
• Osteoporosis is also more common in people who have a small body frame and bone structure. Low body weight also contributes to osteoporosis risk.
• Calcium and vitamin D deficiencies are risk factors for both males and females.

Osteoporosis literally means ‘porous bone’ and occurs when bones become weak and fragile. People who have osteoporosis are at greater risk for fracturing their bones, especially in the hip, vertebrae (spine) and wrist.

For an aging adult, the dreaded risk of breaking a hip is one reason many consider taking osteoporosis medications. Hip fractures often require hospitalization, surgical procedures, and can require lengthy healing periods. Some never fully recover after a hip fracture.

Among the aging, these fractures are a common cause of disability and death, especially in post-menopausal women. Only 40% of hip fracture patients ever regain their independence and nearly 25% die within a year. Vertebral fractures can cause debilitating back pain, and they, too, increase the risk of premature death. (see interesting information at: http://www.health.harvard.edu/diseases-and-conditions/whats_the_story_with_fosamax)

Bisphosphonates have emerged as the leading medication for preventing and treating osteoporosis. Studies show these drugs are effective and safe for up to 5 years. Eventually, however, bone loss continues with bisphosphonates.

So, what does this have to do with your dental health? Keep in mind that the teeth, their roots and the bones that support them are bone. Add to that the fact that many people are often surprised by the wide range of medications that affect their oral health.

Some medications – including prescription, over-the-counter and even herbal supplements – can cause complications during oral surgeries like extractions or dental implant placement. While drugs such as Coumadin, a commonly-prescribed blood thinner, may cause more bleeding during oral procedures, certain drugs create a much greater risk. 

The complication with bisphosphonates, often prescribed to treat osteoporosis, is a risk for jaw osteonecrosis. In simple terms, this is death of the jaw bone. Jaw osteonecrosis occurs when the bone fails to heal after a surgery, even a minor procedure such as a tooth extraction. The risk for jaw necrosis is highest with procedures that directly expose the jaw bone, such as tooth extractions and other oral surgery.

Osteonecrosis results from obstruction of blood supply from the drug’s potential interference with the bone’s ability to repair itself. Initially, it causes pain, swelling or infection of the gums and jaw. It also prevents gum tissues from healing and can lead to tooth loss. Its onset, however, can occur without obvious symptoms.

Trade names of the most prescribed bisphosphonates are Fosamax, Actonel, Boniva, Reclast, Binosto, Prolia, Zometa and Xgeva. The most prescribed, Fosamax, is one of the top 25 most prescribed drugs on the drug market today. Approved by the FDA in 1995, reports began surfacing in 2003 that linked Fosamax with jaw osteonecrosis.

Jaw osteonecrosis risk seems to increase with the amount of time the medications are taken. However, researchers have determined that bisphosphonates can create a risk for necrosis with even short-term use.

In a study of 208 participants who took Fosamax for varying durations, 4% developed osteonecrosis. Not only did the study show that short-term usage can place the patient at risk, the drug can maintain a 10-year ‘half-life’ in bone tissue. This finding was in contrast to the drug makers’ claims that bisphosphonate use only posed a noticeable risk for those who took the medication intravenously, such as in treating cancer patients.

Although the drug makers of bisphosphonates claim a low risk to any adverse reactions, prescribing physicians have often failed to warn patients of actual risks when having dental procedures. This is why it is important to make us aware of all the drugs you take, including over-the-counter types.

Our goal is to provide you with a successful outcome for every procedure. If you have questions regarding the medications you are taking in regard to oral risks, call our office at 828-274-9440.

If You Have Arthritis (RA), Your Oral Health Could Influence Its Severity

Posted on Feb 28, 2017 by William J. Claiborne, DDS MS

As a Periodontal Specialist, I treat all stages of periodontal (gum) disease as well as have particular expertise in the diagnosis and placement of dental implants. Over the years, I’ve watched miraculous progress made in the development of dental implant systems, becoming a dependable, safe and successful alternative to dentures and partials.

Where I’ve not seen much progress is the nation’s understanding of the hazards of periodontal disease. Still today, nearly 47% of American adults have some level of gum disease. And, this is in spite of research findings that have found a correlation between the bacteria of periodontal disease and a long list of serious health conditions. Because of the inflammatory triggers associated with gum disease bacteria, it has been linked to heart disease, stroke, memory loss, preterm babies, diabetes, some cancers and impotency.

In early stages, the condition causes gums to bleed when brushing, bad breath and gum tenderness. As gum disease progresses, gum tissues darken in color and pus pockets form at the base of teeth. Eventually, teeth loosen and require removal. To no surprise, gum disease is the leading cause of tooth loss among American adults.

Research is now showing a remarkably close connection between rheumatoid arthritis (RA) and gum disease. While the connections may seem unlikely, it’s been determined that gum disease and RA share a genetic likeness. Apparently, their clinical structures are similiar, primarily in pathogens, which are agents that causes disease or illness. Studies have noted that the pathological processes that occur in gum disease and RA are nearly identical.

While it has also been established that both conditions cause chronic inflammation in tissues that connect to bone, researchers have found that the two diseases also have a similar inflammatory trigger. The particular species of bacteria found in periodontally-compromised oral tissues and the tissues surrounding RA joints is nearly identical.

RA is a debilitating disease that destroys joints and is disabling and painful. RA typically emerges gradually, often beginning with morning stiffness along with weak and aching muscles. Eventually, joint pain emerges with sore and stiff feelings, typically found in the fingers, wrists, elbows, hips, knees, ankles, toes, shoulder and neck.

As RA-related inflammation worsens, joints become swollen with symptoms including fever, disfiguring of hands and feet, numbness and tingling. While there is no cure for RA, treatment options may include medications, physical therapy, or even surgery to ease the discomfort or slow its progress.

Like RA, gum disease causes pain, swelling, and tenderness. As it worsens, the associated inflammation can destroy the bone that supports teeth along with surrounding tissues. One study even showed a particular pathogen associated with periodontal disease could activate the same destructive process of rheumatoid arthritis. It has also been shown that, by treating periodontal disease in RA patients, RA symptoms often improve. It is suspected that this occurs because the system has a reduced burden of oral inflammation.

An exciting fact on the findings of past research is how oral health correlates so closely to our overall health. Hopefully, as more adults come to realize that the presence of gum disease can so greatly increase your risk for serious health conditions, there will be an increasing trend on achieving and maintaining healthy teeth and gums.

Begin with your own oral health and a healthy body and share this understanding with those you love. Be committed to a thorough oral hygiene regimen at home as well as a your 6-month dental check-ups and exams.

If you have signs of gum disease, seek treatment at your earliest convenience. Gum disease will only worsen and require more treatment time and expense as it progresses. Begin by calling 828-274-9440 to learn more and ask for a consultation appointment.

Afraid Of Going To The Dentist? The Results Can Be Oral Pain AND Pain In The Wallet!

Posted on Feb 21, 2017 by William J. Claiborne, DDS MS

For people who have a fear of heights, it is difficult for those who don’t to understand the emotions that high places can trigger. Or, for people who are afraid of dogs, it can be a rather puzzling problem for those who us who think of our dogs as family.

Fear of going to a dentist is another fear that some individuals have and others do not. And, dental fear is more common than not, with an estimated 75% of American adults having some level of fear or anxiety associated with dentistry.

While people who are fearful of dogs can avoid them much of the time, people who have dental fear pay a high price for avoiding dental care. This ‘high price’ comes in the form of compromised oral health and the need for more-complex treatment that may have been prevented in the first place.

As a Periodontist, I see a great many patients who have acquired gum disease or lost teeth because of dental fear. For most, their fears began following a traumatic experience in a dental chair many years prior. I have also seen some fearful patients who can’t recall exactly when their fears began or why they emerged.

What I have learned in my specialty is that perceived pain can be just as real as actual pain. When someone has been hurt during dental care and the patient felt helpless to halt the pain, it’s logical that they may anticipate similar sensations during subsequent care — UNLESS the patient develops a tremendous amount of trust with their caregivers.

It’s normal that even patients with no fears of dental visits can feel anxious at times. Being positioned on your back on a narrow surface can make anyone feel vulnerable. Added to that? The mouth’s interior is a sensitive area. When you open your mouth for another person to prod around using pointed instruments without knowing what they’re doing, even relaxed patients know there is the potential for an even-slight jab or prick.

I am very proud of the relationship of trust I have with our patients. They know my goal is to NEVER cause them discomfort. Although we cannot always guarantee they’ll have no discomfort at all, my staff and I take extra steps to provide optimal comfort at every visit. This is why we offer oral and I.V. sedation (also referred to as “twilight sleep”) for patients who desire added relaxation throughout their visit.

When it comes to dental problems, the snowball effect begins when patients cannot bring themselves to come into a dental office for care. For those who have fears, just the thoughts of walking in the front door can conjure up uncontrollable reactions. Some patients shake, break out in a sweat, and even cry (both men and women).

From your caregiver’s standpoint, here’s the bigger problem: When dental care is delayed or avoided due to fear, small problems that could have been prevented (or easily treated) become big problems. Big problems require more extensive procedures, more expense and more time in treatment. The fear of going to the dentist simply adds to the need for treatment at the dentist.

Too, when regular dental check-ups and cleanings are avoided, the result can become periodontal (gum) disease and is the nation’s leading cause of adult tooth loss. Periodontal disease occurs when oral bacteria becomes infectious, causing damage to the gums and bone structures underneath the gum tissues. Treatment can be extensive. Additionally, tooth loss can create an entirely new set of procedural needs and expenses.

If you have dental fears, how do you have the care you need when just walking into a dentist’s office is unnerving? We begin with a Consultation in a private room that is removed from the clinical side of the office. We sit in comfy arm chairs and have an open and relaxed conversation. I’ll listen to your concerns and answer your questions and explain comfort options that should work best for your needs. Here, I occasionally find that a patient doesn’t want sedation but just to have treatment administered at a slower pace. That’s fine.

Although we offer relaxation medications in addition to a gentle touch, our patients find that trust is the key to their ability to have the treatment they need. Let us help you overcome your fears or anxiety so you can enjoy the healthy, confident smile you desire.

Remember, delay can result in more treatment, more expense and more time. Call 828-274-9440 to arrange a consultation appointment soon.

Weighing Benefits Of Dental Implants Vs. Crown-&-Bridge

Posted on Feb 17, 2017 by William J. Claiborne, DDS MS

When an adult is missing one, two, or several teeth in one area, a common replacement option, for many, has been a crown-&-bridge combination. This often because a bridge, in most cases, costs more than Dental Implants – initially. Yet, does the ‘initial’ investment of a bridge outweigh the long-term expenses commonly associated with its upkeep?

Dental Implants are held in the jaw bone, just like natural tooth roots. This means that they do not rely on adjacent teeth for support. They do not require the support of natural teeth that must be crowned merely to serve as supports for a bridge. By keeping your natural teeth ‘natural,’ you are able to protect the long-term benefits to your oral health.

Dental Implants are designed to last for a lifetime, making them an excellent investment. They will never need a root canal or repair of cavities. It is a fact that the teeth adjacent to a missing tooth are most likely next in line to require removal.

Dental Implants are designed to replace missing teeth using the natural foundation of your jaw bone. Once placed, Dental Implants integrate into the structure of your bone. Through this, they help to prevent the bone loss and gum recession that often accompany bridgework and partials.

Over time, bone loss becomes obvious through changes in facial appearance. Bone loss contributes to deep wrinkles around the mouth, causing the corners of the mouth to turn downward even in a smile. Eventually, many develop a collapsed appearance of the mouth. This creates a ‘granny look’ that contributes to an appearance far older than your actual age.

Because some people prefer to keep their Dental Implant treatment a private issue, no one need to ever know you have implant-supported teeth. While some implant systems allow you to remove attached teeth, many versions are non-removable. Non-removable types mean you’ll never have to remove your teeth from your mouth. You’ll wake up with a smile and brush your implanted teeth along with your natural teeth!

The success rate of Dental Implants is excellent. Properly selected, placed and maintained, this lifetime solution makes them a wise choice when it comes to tooth replacement. Since Periodontists specialize in gum tissues and underlying bone in the mouth, they have the knowledge, training and facilities to give you teeth that look and feel just like your own.

When you consider Dental Implants based on the long-term advantages and the ‘one and done’ cost versus , the choice is an easy one. Obviously, Dental Implants are a wise investment. To arrange a consultation to discuss your needs, call (828) 274-9440.