Since the early 1970’s, medication has been used to slow down the breaking down of bone diseases such as metastatic bone cancer and osteoporosis.
These drugs are called bisphosphonates which slow down the function of specific cells called osteoclasts. There are different names for the drugs in this category, and many of them are taken a pill.
In a healthy body, osteoclasts process mature bone when required and pull calcium out of them when the body needs it. Also, it helps the body grow by removing dead bone. Osteoclasts help to transfer chemical messengers to another cell called osteoblasts to enhance the formation of new bone. In a healthy body, the process is called remodeling which helps to improve growth and healing throughout life.
The osteoclasts break down quickly compared to the osteoblasts in re-establishing new bone.
The goal of bisphosphonate treatment is to rebuild the balance between the two. Most times, they function reasonably well and are important in reducing the pain that comes from catastrophic fractures of the spine, wrist, and hip in people who have osteoporosis. It helps to reduce the high levels of calcium in the blood that can develop in those who have metastatic bone cancer. Therapeutic dosages of treatments can be prescribed, however, it is not possible to prescribe bisphosphonate therapies to rebuild the harmony of bone remodeling which exists in a healthy individual.
Just like other drugs, the side effects cannot be avoided.
Regarding bisphosphonate medications, a serious side effect has been found called bisphosphonate-related osteonecrosis of the jaw. This occurs after dental implant placement or dental extractions. Other contributing factors include smoking periodontal disease, malnutrition, and alcohol abuse. Osteonecrosis occurs as a result of dead bone in a localized site that may or may not become infected. The treatment is unpredictable, and healing of bisphosphonate-related osteonecrosis may be impossible.
Due to the extremely rare side effect, osteoporosis can reduce the quality of life of people suffering from it. Also, dentists like Dr. Levine and Dr. Bers are concerned about not extracting teeth in patients that use bisphosphonate treatment. It has significantly affected the way dentists prescribe drugs for these individuals. For instance, performing root canal therapy on broken roots is a wise treatment over-extraction in these patients.