{"id":147,"date":"2015-03-31T13:08:27","date_gmt":"2015-03-31T12:08:27","guid":{"rendered":"https:\/\/www2.dental-focus.co.uk\/belmore\/blog\/?p=147"},"modified":"2021-05-04T10:59:37","modified_gmt":"2021-05-04T09:59:37","slug":"oral-surgery-bisphosphonates","status":"publish","type":"post","link":"https:\/\/www.belmoredental.co.uk\/blog\/oral-surgery-bisphosphonates\/","title":{"rendered":"Oral Surgery & Bisphosphonates."},"content":{"rendered":"
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BISPHOSPHONATES\u00a0AND\u00a0SURGERY<\/span><\/p>\n

Is there a risk to taking Fosamax\u00ae and\u00a0other bisphosphonates when preparing for\u00a0surgery?<\/span><\/p>\n

If you are scheduling an upcoming surgical procedure, be sure\u00a0that all of the healthcare professionals involved are aware of any\u00a0prescription medications, over-the-counter (OTC) medications\u00a0and even herbs or home remedies that you are currently taking.\u00a0This is especially true if you are taking the prescription Fosamax\u00ae\u00a0(alendronate) or another drug in the bisphosphonate family. If not\u00a0stopped at least three months prior to surgery, you are at risk for\u00a0developing osteonecrosis\u2014literally bone death. For oral surgery\u00a0patients, most cases reported occurred after a dental extraction;\u00a0however, it can also occur spontaneously and may be associated\u00a0with pain at the site.<\/span><\/p>\n

Our understanding of bisphosphonates is evolving and it is\u00a0certainly not an exact science presently. What we do know is that\u00a0bisphosphonates are not metabolised quickly in the body, but stay\u00a0within the bone tissue for many years. If any type of treatment is\u00a0planned which involves surgery to the jaw bone, there is a risk\u00a0that osteonecrosis may develop if the precaution of stopping the\u00a0drug and waiting for a three month period is not taken.\u00a0Precautions for elective surgery are now recommended for those\u00a0who have taken Fosamax\u00ae for more than three years although\u00a0the risk of osteonecrosis is very small. The cause of this condition\u00a0is not fully understood. The general mechanism appears to involve\u00a0a compromise of the blood supply to the bone. There are risk\u00a0factors that make an individual more vulnerable to developing\u00a0osteonecrosis; they include, but are not limited to, corticosteroid\u00a0use, diabetes, alcohol abuse, tobacco use, infections and\u00a0inflammation. The increase in concern is that bisphosphonates\u00a0may be associated with a form of osteonecrosis that is specific\u00a0to the jaws. Over the past few years there have been a growing\u00a0number of cases reported.<\/span><\/p>\n

Osteonecrosis of the jaw may result from trauma in patients\u00a0taking bisphosphonates. Most case reports have occurred after \u00a0dental extraction, but can also occur spontaneously and may be\u00a0associated with pain at the site. The cause of the condition is not\u00a0defined and may include the possibility of bisphosphonates altering\u00a0the formation of blood vessels or bone micro-architecture.\u00a0Most cases of osteonecrosis of the jaw appear to occur in patients\u00a0who have been on intravenous bisphosphonate infusions, as part of\u00a0treatment for cancer. The reported incidence in patients receiving\u00a0intravenous bisphosphonates is 0.8% to 12%. The reported\u00a0incidence in patients on oral bisphosphonates, such as Fosamax\u00ae is much less, 0.01% to 0.04%. Following teeth extractions, the\u00a0incidence increases, but is still small, 0.09% to 0.34%.\u00a0The optimum duration of bisphosphonate treatment has not been\u00a0defined and studies are investigating long term dosing regimens\u00a0to determine the best utilisation of this drug. For patients on oral\u00a0bisphosphonate medications, initial studies seem to indicate that\u00a0three years of therapy makes patients more vulnerable. Studies\u00a0that have gone up to two years in duration have not shown\u00a0any adverse effect. These studies also suggest that stopping\u00a0a bisphosphonate for 3 months prior to a procedure seems to\u00a0reduce the incidence of osteonecrosis. It is puzzling that some\u00a0bisphosphonate treatment may be associated with osteonecrosis\u00a0of the jaw where as other bisphosphonates have been used to\u00a0treat similar conditions, for example, avascular necrosis (loss of\u00a0blood vessels resulting in bone death) of the hip. This suggests\u00a0that further research is necessary to understand the cause of\u00a0osteonecrosis.<\/span><\/p>\n

If you are worried about taking bisphosphonates and oral surgery then please call us on 02866 329222 and speak with one of our oral surgeons. You can also email sinead@belmoredental.co.uk<\/u><\/a>.<\/span><\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

BISPHOSPHONATES\u00a0AND\u00a0SURGERY Is there a risk to taking Fosamax\u00ae and\u00a0other bisphosphonates when preparing for\u00a0surgery? If you are scheduling an upcoming surgical procedure, be sure\u00a0that all of the healthcare professionals involved are aware of any\u00a0prescription medications, over-the-counter (OTC) medications\u00a0and even herbs or home remedies that you are currently taking.\u00a0This is especially true if you are taking the … Continue reading Oral Surgery & Bisphosphonates.<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":274,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,11,12],"tags":[],"class_list":["post-147","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-cosmetic-surgery","category-dental-implants"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.belmoredental.co.uk\/blog\/wp-json\/wp\/v2\/posts\/147","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.belmoredental.co.uk\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.belmoredental.co.uk\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.belmoredental.co.uk\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.belmoredental.co.uk\/blog\/wp-json\/wp\/v2\/comments?post=147"}],"version-history":[{"count":1,"href":"https:\/\/www.belmoredental.co.uk\/blog\/wp-json\/wp\/v2\/posts\/147\/revisions"}],"predecessor-version":[{"id":148,"href":"https:\/\/www.belmoredental.co.uk\/blog\/wp-json\/wp\/v2\/posts\/147\/revisions\/148"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.belmoredental.co.uk\/blog\/wp-json\/wp\/v2\/media\/274"}],"wp:attachment":[{"href":"https:\/\/www.belmoredental.co.uk\/blog\/wp-json\/wp\/v2\/media?parent=147"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.belmoredental.co.uk\/blog\/wp-json\/wp\/v2\/categories?post=147"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.belmoredental.co.uk\/blog\/wp-json\/wp\/v2\/tags?post=147"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}