Preventive Care

Osteoporosis Medications:

From the moment we are born until our early twenties, our bones grow denser and thicker as our skeletons develop. We continue to build bone mass until our early twenties, when our bones are at their strongest. As we grow older, our bones begin to lose their density and strength as part of the aging process, especially after we reach our fifties. OSTEOPOROSIS or porous bone, is a disease that weakens bones and makes them more likely to break. Osteoporosis can lead to broken bones especially of the hip, spine and wrist.

To prevent broken bones, many people with low bone density or osteoporosis take medications from a group of drugs called Bisphosphonates(bis-fos-fo-nates). These medications include: Aledronate(Fosamax), Ibandronate(Bonivia), Risedronate(Actonel), and Zoledronic Acid(Reclast).

Bisphosphonate medications help reduce the chance of broken bones by reducing bone loss and increasing bone density. However, recently new reports have alarmed and confused people who take bisphosphonates to prevent or treat osteoporosis. That’s because of a condition known as osteonecrosis of the jaw (also know as ONJ). Bisphosphonate associated osteonecrosis of the jaw is a rare but serious condition that can cause severe damage to the jawbone. Osteonecrosis of the jaw bone is diagnosed in patients:

  • who has an area of exposed bone in the jaw that persists for more than 8 weeks.
  • who has no history of radiation therapy to the head and neck.
  • who is taking or has taken a bisphosphonate medication.

The majority of people diagnosed with osteonecrosis of the jaw are cancer patients who are receiving or did receive repeated high doses of bisphosphonates through an intravenous (IV) infusion. The minority of people with osteonecrosis of the jaw were people taking oral bisphosphonates for treatment of osteoporosis. Your chance of developing osteonecrosis of the jaw if you are taking bisphosphonate medication for osteoporosis is unknown. However, researchers agree that the chance appears to be very small.

Tell Your Dentist:
Tell your dentist if you are prescribed a bisphosphonate medication. Your dentist will show you good oral hygiene practices, as well as monitor your dental and oral health while you take the medication. The medical and dental communities continue to research how to prevent and treat bisphosphonate associated osteonecrosis of the jaw to ensure the safety of patients taking bisphosphonate medications.

Pregnancy Gingivitis:

HAVING A BABY?
Your teeth and gums need extra care and attention, pregnancy causes hormonal changes that increase your risk for developing oral health problems like GINGIVITIS(inflammation of gums) and PERIODONTITIS(gum disease), as a result 50%-70% of women will develop gingivitis during pregnancy. The increase level of progesterone hormone during pregnancy may make it easier for certain gingivitis causing bacteria to grow as well as make gum tissue more sensitive to plaque and exaggerate the body’s response to toxins that result from plaque.

WHY IS ORAL HEALTH IMPORTANT DURING PREGNANCY?
Mothers with gum disease have a higher instance of preterm birth, a potentially serious pregnancy complication that may cause health concerns for their infant, typically due to a low birth weight. Pregnancy gingivitis is a common form of gum disease known to develop in almost half of all pregnant women due to the change in hormones. When kept at bay, pregnancy gingivitis generally ends shortly after the birth of a child, although it should be monitored by a dentist periodically during pregnancy to prevent this form of gingivitis from progressing into more serious periodontitis, an advanced and irreversible form of gum disease that has been linked with preterm birth. Prostaglandin, a chemical found in oral bacteria, may induce labor and high levels of prostagladin has been found in the mouths of women with severe cases of periodontal disease.

SIGNS AND SYMPTOMS:
Gum inflammation appears between the second and eight month of pregnancy. Gums appear more red, bleed easily upon brushing, swelling, and bad breath. Sometimes a large lump with deep red pinpoint markings form on inflamed gum tissue near the upper gum line and cause discomfort. These growths are pregnancy tumors, called pyogenic granulomas, and can occur during the second trimester.

TREATMENT AND TIPS TO PREVENT PREGNANCY GINGIVITIS:

  • Oral Health Education: Counseling and early intervention by healthcare providers such as physicians, nurses, and dentists to provide expectant mothers with tools and resources necessary to understand the importance or oral health care during pregnancy.
  • Oral Hygiene: Removing the bacteria plaque is essential, using correct brushing and flossing methods greatly increase the amount of plaque that is removed from the teeth and gums.
  • Fluoride: The American Dental Association recommends the use of toothpaste with fluoride by persons over the age of six. Continued use of fluoridated toothpaste during pregnancy and the use of over the counter alcohol free fluoride rinse to help reduce the amount of plaque in the mouth. Fluoride will help to strengthen the enamel to prevent sensitivity that may develop from acid erosion on teeth due to vomiting from morning sickness during pregnancy.
  • Nutrition: Educating expectant mothers about proper diet and nutrition during pregnancy will limit unnecessary sugar intake and in turn prevent plaque build up.
  • Treating Existing Tooth Decay: Expectant mothers are encouraged to have existing tooth decay ( cavities) treated during their pregnancy, which experts believe is a completely safe practice during pregnancy. Restoring decayed teeth will help achieve oral health by removing the bacteria associated with tooth decay.
  • Transmission of Bacteria: Expectant mothers are discouraged from sharing food and utensils in order to prevent the transmission of bacteria known to cause tooth decay.

Practice good oral hygiene, brush twice a day, floss daily, and use an antimicrobial mouthrinse. A pregnant woman should see a dentist in the first three months of pregnancy. She should have her teeth cleaned to help prevent gum disease. The dentist will also check for tooth decay or other problems. If you are due for a professional cleaning, don’t skip it simply because you are pregnant. Now more than ever, professional dental cleanings are particularly important.