Oral Health Effects of Antiresorptive Medications

By Yusuke Hamada, DDS, MSD; Apoorv Goel, BDS, MS; Yu-Ting Yeh, DDS; and Vanchit John, BDS, MDS, DDS, MSD

Osteoporosis can impact a patient’s quality of life due to the possibility of bone fractures. According to data from the National Health and Nutrition Examination Survey, the prevalence of osteoporosis in older United States adults ranges from 6% to 11%.1Accordingly, antiresorptive medications—such as bisphosphonates and receptor activator of nuclear factor kappa-Β ligand (RANKL) inhibitors, which help in the management of osteoporosis—are commonly prescribed. These agents are also used to treat bone diseases, such as Paget’s disease, hyperparathyroidism, and osteogenesis imperfecta, as well as primary bone malignancy or metastatic bone malignancy from various cancers.2However, according to a survey by Tanna et al,3 while most dental practitioners were familiar with bisphosphonates, more than 90% were unaware of the other antiresorptive medications that can cause medication-related osteonecrosis of the jaw. Antiresorptive therapies for individuals with osteoporosis include five principal classes of agents: bisphosphonates, estrogens, selective estrogen receptor modulators, calcitonin, and monoclonal antibodies, such as denosumab. While each has the potential to cause osteonecrosis, bisphosphonates are the main focus of this article because they are the most commonly prescribed antiresorptive agents.4,5 As such, clinicians should be mindful of strategies that can help these patients maintain optimum oral health.

* References can be found in the original article via the link below.
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