A reader asks: I recently fell and broke my wrist and my doctor arranged for me to have a bone density scan. The result has shown I have osteoporosis. It has been recommended I take a weekly tablet for this. However, my GP was insistent I see my dentist before I start taking them. Why was this? Will they harm ny teeth?
Dr Rosemary Leonard replies: The most commonly used drugs to treat osteoporosis are bisphosphonates, such as alendronic or ibandronic acid, while more powerful versions, such as zoledronic acid, can be given intravenously. Bone tissue is constantly being broken down and reformed, and these drugs work by slowing down the breakdown of bone.
There is good evidence they can help prevent bones weakened by osteoporosis getting any worse – and in some cases may help to build new bone and improve density so people who take bisphosphonates are less likely to have fractures. But as with all medications, bisphosphonates can have side effects such as flu-like symptoms, muscle pain and inflammation of the oesophagus. A condition known as osteonecrosis of the jaw can also occur, where the jawbone that has been exposed after a tooth removal loses its blood supply, causing it to become inflamed and painful.
This is extremely rare, especially with bisphosphonates taken by mouth, but as a precaution it is best to have a dental check-up and have any work needed, especially extraction, done before treatment with bisphosphonates is started. You should also tell your dentist about your new medication, and ensure you have regular dental checks and also a thorough professional clean at least every six months. But don’t worry about this – even if you did need to have a tooth out after starting treatment it is very unlikely you’d have problems afterwards.
If you have a health question for Dr Leonard, email her in confidence at yourhealth@express.co.uk. She regrets she cannot enter into personal correspondence or reply to everyone
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