Medical History Mysteries: Osteoporosis and dental treatment—bisphosphonates

May 12, 2022
Bisphosphonates can have a negative effect on the jaw bones. What do dental professionals need to know about patients with advanced forms of osteoporosis? Drs. Pamela Maragliano-Muniz and Tom Viola discuss.

Welcome to Medical History Mysteries, where we dissect our patients’ medical histories and figure out how best to treat them from the dental chair.

Last week we talked about patients who have osteopenia and osteoporosis, and what their medical history might look like.

In this episode, we’ll consider patients who have advanced forms of osteoporosis and are taking bisphosphonates. What do we need to know about bisphosphonate therapy in dentistry, what are the dental considerations, and how can dental professionals help mitigate some of the issues?

Bisphosphonates originated as drugs to treat bone cancer. They reduced bone turnover and were antiangiogenic. The problem is, some bones in the body need turnover (especially the mandible, maxilla, and femurs), and they rely heavily on blood supply. Bisphosphonates cause the jaw bones and femurs to accumulate constant microdamage to their inner architecture, and eventually those microfractures cause the bones to collapse. Sometimes osteonecrosis occurs, making infections more likely. But dental professionals can have a positive influence on the health of these patients.

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Editor’s note: This article first appeared in Through the Loupes newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles and subscribe to Through the Loupes.

About the Author

Pamela Maragliano-Muniz, DMD

Pamela Maragliano-Muniz, DMD, is the chief editor of DentistryIQ and editorial co-director of Through the Loupes. Based in Salem, Massachusetts, Dr. Maragliano-Muniz began her clinical career as a dental hygienist. She went on to attend Tufts University School of Dental Medicine, where she earned her doctorate in dental medicine. She then attended the University of California, Los Angeles, School of Dental Medicine, where she became board-certified in prosthodontics. Dr. Maragliano-Muniz owns a private practice, Salem Dental Arts, and lectures on a variety of clinical topics. You may contact her at [email protected].


Pamela Maragliano-Muniz, DMD, named chief editor of DentistryIQ

About the Author

Tom Viola, RPh, CCP

With more than 30 years’ experience as a board-certified pharmacist, clinical educator, professional speaker, and published author, Tom Viola, RPh, CCP, has earned the reputation as the go-to specialist for making pharmacology practical and useful for dental teams. He is the founder of Pharmacology Declassified and is a member of the faculty of more than 10 dental professional degree programs. Viola has contributed to several professional journals and pharmacology textbooks, and currently serves as a consultant to the American Dental Association’s Council on Scientific Affairs.

Updated February 10, 2022