Dr Gatti's Blog a Lawrence Dentist Reflections

Medications you take for osteoporosis can have an impact on your dental health

Recent news reports have alarmed and confused dentists, as well as people who take bisphosphonates (bis-fos-fo-nates). That is because a condition known as osteonecrosis (os-tee-oh-ne-kro-sis) of the jaw (also know as OJN) has been reported in some patients who have taken these medications. Bisphosphonate associated osteonecrosis of the jaw, or BON, is a rare but serious condition that can cause severe damage to the jawbones.

Since there is so much confusion on the subject I wanted to give you a brief overview of the current recommendations and suggestions of what to consider.

First, this is a real event. However, the overwhelming majority of people (94%) diagnosed with BON are cancer patients who are receiving or did receive repeated high doses of bisphosphonates through intravenous (IV) infusion. The other 6% of people with BON were taking oral bisphosphonates for treatment of their osteoporosis.

Given this information there are practical matters to consider. First, osteoporosis and broken bones are serious. The statistics around hip fractures and mortality in people over 50 are somewhat frightening. Studies indicate that in many people, bisphosphonate medication can help reduce the chance of broken bones by increasing bone density. Some reports indicate that these medications may reduce the chance of hip fracture by 50% in people with osteoporosis.

So, like everything in life, there are risks and rewards. In the instance of osteoporosis, the benefits of these medications greatly outweigh the low risk of developing BON. Bottom line, if you are taking bisphosphonate medication, don’t go off your meds unless you have had a serious conversation with your physician. Practically speaking, if systemic conditions permit, initiation of bisphosphonate therapy should be delayed until dental health is optimized. It is imperative that the decision is made in conjunction with your treating physician and oncologist.

Once again, regular dental visits and excellent oral hygiene practices may be the best way to reduce your risk.

Is an electric toothbrush really that much better than a regular brush?

The sooner you throw out that standard toothbrush the better! The benefits of replacing a standard toothbrush with a quality electric model are substantial for both adults and children. Electric toothbrushes generally make 20,000 to 40,000 brushstrokes per minute. The human hand just can’t compete with that!

The electric brushes do cost more, but they can be more effective in keeping teeth clean too, saving time and cost by preventing the need for future dental work. They are also especially helpful for those who aren’t able to clean their teeth thoroughly with a standard brush due to physical or mental disabilities.

Electric brushes come with many different features and it can be confusing trying to decide which brush to purchase. The next time you are in, be sure to ask us if you would like help in choosing which brush is best for you and how to use it correctly.

Many of you have invested a significant amount of time and energy for a fantastic smile. Maybe you have veneers, porcelain crowns or have whitened your teeth. The best way to maintain oral health is with daily care; yes, flossing as well as brushing. Bottom line, using an electric toothbrush will be more effective.

To sum it up, one of my clients told me that brushing now with a standard brush is like taking half a shower. It just isn’t the same! Happy Brushing! But don’t forget flossing!

Summer Is Here!

Even if I lived in a closed box I think I could tell when summer arrives by the phone calls and questions I receive. With people going out of town for vacation or having guests with them, dental concerns take an elevated status. The panic factor increases. So I wanted to review a couple of common scenarios that seem to occur more at this time of year.

I am at my sister’s and I just had a crown come off, what should I do?

First, there are many reasons that a crown might come off, so if possible, visit her dentist and have it temporarily cemented. If that is inconvenient you can go to the drug store and buy a denture adhesive. Clean out the crown as well as possible and add a very slight amount of denture adhesive to the inside of the crown. In this situation very little is needed. The crown will only go back on one way – give it a few trial runs before putting in the adhesive. Once comfortable with the orientation, put the crown to place with the adhesive inside of the crown. Please understand that this is a temporary fix. You will be able to dislodge it with chewy or sticky food, so be careful. The reason it is important to place the crown back in your mouth if at all possible is to preserve the space. Teeth shift and drift until they hit something. If the crown is left out for a period of a week or so it may no longer fit the space.

I just bit into something and part of my tooth broke!!!!

Most of the time, this is much more startling than painful. The worst pain will be when it first happens. Usually the tooth will be sensitive to cold; however you will be surprised that it is not worse because it will feel like a huge hole in your mouth.  Most likely it will be fine and we can deal with it when you get back home. Again, the normal initial response is one of panic. What is typical is that it is rather sharp to your tongue, but otherwise not terrible.

My parents are visiting and my dad’s tooth just……… (You fill in the blank)

Give us a call. I am sure that we can find a way to help get him taken care of or at least get him comfortable until he gets back home.

Regardless of the situation, please remember that you can always give me a call. If I am not in the studio, our voice mail will give you my cell phone – call me. There is no need to have pain or panic ruin your vacation. We can usually get things under control pretty quickly.