Osteoporosis and oral cavity

Autor: comunicación tellmeGen

Osteoporosis is the result of a loss of bone mass and a change in bone structure.

Bone is a living tissue that is in a constant state of regeneration, what means that the body is able to eliminate the most damaged and weak cells that make up the bone, bone resorption process, and replace them with new cells that make up new tissue, bone formation process.

Osteoporosis is a disease in where the bones become more porous, increasing the number and size of cells or cavities that exist inside. As people gets older, most people slowly lose more bone mass than they can replace. In this way, the bones become more fragile: they resist the hits worse and they break more easily, being the fractures the main symptom and consequence of this disease, besides the pain and the incapacity.

Osteoporosis is more common in women over 50, mainly women. Even so, it can occur at any age, in both sexes and in all ethnic groups.

Most people with osteoporosis moreover than following healthy lifestyle habits, which include proper physical exercise and calcium and vitamin a supplements, will also need medication.

Among the medication administered to these patients are drugs that inhibit bone resorption such as bisphosphonates or Denosumab, both are widely used nowadays. Bisphosphonates act by depositing on the bone and preventing it from being reabsorbed. The Denosumab acts directly on the osteoclast preventing their action and the bone resorption. Both drugs act in the maxilla and the jaw, and thatʼs one of the main side effects of these drugs, it is located in them  and itʼs jaw´s osteonecrosis one of the process of osteomyelitis (bone infection) which is developed slow and torpid . This complication is favored by surgical processes that affect the bone, such as tooth extraction.

How do osteoporosis treatment drugs affect dental treatment plans?

Osteoporotic patients can be treated as normal pacients, but it is important that they consult about the drugs they take and their possible side effects.

• Always try to preserve the teeth and avoid as much as possible the actions that require bone manipulation such as extractions, implants, or surgeries.
• There is no absolute contraindication, but there is a greater risk of developing jawʼs  osteonecrosis that increases with the power and time of administration increase.
• Therefore, people should always inform the dentist about the use of this type of drugs, their  type and the time they have been taking.

In relation to advances in the field of genetics, it is important to note that not only certain genomic variants show the predisposition to different diseases, including autoimmune diseases, but also the Precision Medicine takes on a vital importance at the time to improve and optimize pharmacological treatments, achieving individualization to achieve excellence.

In addition, some genetic alterations seem to be associated with an increased risk of  osteonecrosis of the jaws and studies are currently determining these genetic markers that can predict which patients have an increased risk of developing this complication when taking anti-vasoactive drugs.

Therefore, prevention measures are so important. But not only that, it is also important to know the individual susceptibility, since it is a disease with an important genetic load. This fact will  allow us to face it in a more active and effective way to the treatment and the prevention of the complications derived from it.