Posts for: August, 2014
If you have osteoporosis, one of the drugs you may be taking is alendronate, more commonly known by the brand name Fosamax®. Alendronate is a member of the bisphosphonate drug family, which inhibit bone resorption (the loss of bone mass). While an effective treatment of osteoporosis, alendronate may cause an opposite side effect in other areas of the body, the inhibition of new bone growth. This effect on the jaw in particular could result in an adverse reaction after dental surgery.
The main concern is a condition called osteonecrosis, or literally “bone death.” Bone tissue normally goes through a cycle of resorption (the dissolving of bone tissue) and new growth to replace the cells that have been lost through resorption. Osteonecrosis disrupts the growth phase so that the bone doesn’t recover properly after resorption. This results in the bone becoming weaker and less dense.
There have been a number of cases of increased osteonecrosis in patients on alendronate after experiencing trauma to the mouth. This includes dental surgery, particularly tooth extractions. In addition, patients with certain risk factors like diabetes, tobacco use or corticosteroid therapy appear more vulnerable to osteonecrosis.
Although the risk of osteonecrosis after dental surgery is small, many dentists recommend stopping the use of alendronate for three months before the procedure if you’ve been taking the drug for more than three years. This recommendation is based on a number of studies that seem to indicate three or more years of bisphosphonates therapy makes patients especially vulnerable to osteonecrosis. These studies also indicate stopping the therapy for three months significantly reduces the risk of developing the condition.
There’s still much to be learned about this link between alendronate therapy and dental health. It’s a good idea, then, to let us know what medications you’re taking (especially bisphosphonates) whenever you visit us for an exam. Knowing all your medications will help us develop the safest and most effective treatment plan for your dental care.
If you would like more information on bisphosphonates and their effect on oral health, 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 “Fosamax and Surgery.”
As a successful author, interior design guru (with 127 makeovers in eight years on The Oprah Winfrey Show), and host of his own television program, The Nate Berkus Show, Nate Berkus understands the important role a beautiful smile plays in one's life and career. In a recent interview with Dear Doctor magazine, Nate discussed his oral health history. Berkus credits his all natural smile — no cosmetic dentistry here — to the treatments he received as a child from his dentist. “I'm grateful for having been given fluoride treatments and sealants as a child.” He then added that, “healthy habits should start at a young age.”
Dental sealants are important because they help protect developing young teeth until the enamel has matured. Without dental sealants, the newly erupted immature enamel of teeth is more permeable, meaning that the acids produced by bacteria in the mouth can damage these teeth more easily. This makes the teeth less resistant and thus more susceptible to tooth decay.
Regardless of how much your children brush their teeth, the reality is that toothbrush bristles cannot reach down to clean out the crevices found in the deep grooves (“pits and fissures”) of teeth. And if not removed, the bacteria found in these grooves produce decay-causing acids as a byproduct of metabolizing sugar. However, when sealants are used in combination with fluoride, good hygiene and nutrition (including lower sugar consumption), the odds of having tooth decay is dramatically reduced.
We refer to dental sealants as “pit and fissure” sealants because they protect the grooves found in the top of back teeth and the back of front teeth. Sealants also may reduce the need for subsequent treatments as your child grows older — just as it did for Nate Berkus. For these reasons, sealants are definitely something that all parents and caregivers should consider for their young children.
To learn more about dental sealants, contact us today to schedule an appointment so that we can conduct a thorough examination, discuss any questions you have as well as what treatment options will be best for you or your child. Or to learn more about sealants now, you can continue reading the Dear Doctor magazine article “Sealants for Children.” And to read the entire interview with Nate Berkus, please see the Dear Doctor magazine article “Nate Berkus.”
There’s a new focus on children’s nutrition by both parents and schools; in fact, many school districts have instituted policies that encourage children to eat more nutritional foods and snacks. Regarding snacks in particular, the United States Department of Agriculture (USDA) recently released new regulations for the Smart Snacks in Schools Initiative that call for more whole grains, fruits and vegetables and less fat, sugar and salt in snack foods.
These regulations will help fight obesity and related medical problems like diabetes, but many dentists don’t believe they go far enough in one particular area — the consumption of sugar, a major cause of tooth decay. Dentists also feel the guidelines are too generous in the amount allowed for highly acidic beverages like sodas, ice tea, sports drinks and energy drinks that increase the risk of enamel erosion and tooth decay.
You may also be concerned about how much sugar your child is eating, and for the most part you’re able to manage their intake when they’re at home. But what can you do to influence their snack choices and habits when they’re at school?
For one thing, get involved with your child’s school and with other parents. Let school officials know your concerns about the sugar, fat and salt content of the snacks offered in the school’s vending machines and food service, and work to implement policies that discourage less nutritional snack foods. You should also set limits for your children about what snacks they can buy at school — along with explaining why they should avoid certain kinds of snack foods in favor of others. And, be sure to send healthy snacks along with them when they go to school that are bite-sized and fun.
It’s also important to help your children limit how often they snack and avoid “grazing” — nibbling on snack food for hours on end. Grazing can cause the mouth to be continuously acidic and never allow saliva an opportunity to neutralize the acid. You can also suggest similar policies to school officials, such as shutting down vending machines at certain times of the day.
Nutrition is essential to good health, in the mouth as well as the rest of the body. As a parent, it’s your job to see that your children eat nutritiously — enlisting their schoolâ??s help will make that job a little easier.
If you would like more information on dental-friendly snacking, 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 “Snacking at School.”