Osteoporosis Drugs Delay Healing After Tooth Extraction

Osteoporosis Drugs Delay Healing After Tooth Extraction

A new study finds that long term use of bisphosphonates (drugs used for the prevention and treatment of osteoporosis or other bone weakness conditions) does not delay your healing after having a tooth extracted. If you have taken bisphosphonates for more than five years, healing of a tooth extraction socket will be significantly delayed (as tooth extraction SM - paid - shutterstock 1284549592compared to those not taking one of these drugs).

What are Bisphosphonates?

“Bisphosphonates are a group of medicines used to treat bone problems, such as thin or fragile bones. . . They are commonly used to treat bone disorders such as osteopenia, osteoporosis, Paget’s disease, and metastatic bone disease.” [American College of Rheumatology, https://www.rheumatology.org]

Drugs in the family of bisphosphonates include:

  • Oral: Alendronate (Fosamax), risedronate (Actonel), and ibandronate (Boniva)
  • IV: Pamidronate, and zoledronic acid (Reclast/Zometa)

The goal of the study was to determine whether stopping these drugs prior to a tooth extraction is advisable to prevent bisphosphonate-related osteonecrosis of the jaw (BRONJ). “Osteonecrosis of the jaw, commonly called ONJ, occurs when the jaw bone is exposed and begins to starve from a lock of blood. Most cases of osteonecrosis of the happen after a dental extraction. [American College of Rheumatology]

Why does this Study Matter in Dentistry?

The study demonstrated that long-term use of bisphosphonates (more than 5 years) significantly delayed the healing of an extraction socket when compared to use of these drugs for less than 5 years. Bisphosphonate-related osteonecrosis of the jaw did not develop in any group in the study.

The study also found that healing time was not affected by systemic risk factors: glucocorticoid administration, diabetes mellitus. There were also no adverse effects to the bone, such as fracture.

Many dentists (including our practice at Complete Dental Care in Salem, VA) have asked patients to stop taking bisphosphonates prior to tooth extraction in order to allow normal healing of the tooth socket. This study supports the claim that stopping these drugs is not necessary, particularly if you have been taking the drugs for less than five years. There have been differences of opinion about the effect of osteoporosis medications on tooth extractions. This research settles the question for dentists.

We always ask you what medications you are taking before beginning any dental procedure. If we do not know you are taking a particular drug, we cannot calculate how it would affect your health during or after the procedure. If you tell us you are taking an osteoporosis medication (for prevention or treatment), we may want to know more about your medical history. Then we can evaluate any risk to your health prior to the procedure.

All of us at Complete Dental Care in Salem, VA are committed to protecting and preserving your health.