In the spirit of St. Valentine’s Day, “The best and most beautiful things in the world cannot be seen or touched. They must be felt with the heart.” – Helen Keller
It’s been four years since I wrote about bisphosphonates and there has been some new studies that I wanted to make my patients aware of. The use of bisphosphonates in the U.S. is widespread and it is traditionally used by women over the age of 65, who have osteoporosis. Some oncologists are using it as an adjunct in patients suffering from multiple myeloma & metastatic prostate cancer. The bisphosphonates given to these cancer patients is usually administered I.V. Because the dosage is so high with the I.V. therapy it is recommended that these patients have a comprehensive oral exam performed and all dental infections removed. In addition, it is recommended that all tori and impacted teeth be removed and any dentures or partials be remade. I.V. treatment should be delayed for one month after invasive dental procedures and the patient placed on a three month evaluation schedule. For patients on oral bisphosphonates they should be informed of the risk of bisphosphonate induced osteonecrosis and consider either discontinuing the drug or taking a “drug holiday”. Be aware that the bone rebuilding capabilities of this drug family is maximized at five years and further therapy has no discernable benefits.
If you or someone you love has questions about bisphosphonate therapy please contact our office for a complimentary consultation.
Michael W. Dagostino, DDS