My Blog

Posts for: March, 2021

By Don Fortner, DMD
March 26, 2021
Category: Oral Health
Tags: osteoporosis  
CertainDrugsforOsteoporosisCouldImpactYourDentalCare

Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.

From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.

Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.

These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.

Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.

Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.

If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown.  If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.

Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.

If you would like more information on osteoporosis and dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Osteoporosis Drugs & Dental Treatment.”


IncludeTheseImportantNutrientsonYourDinnerPlateforStrongerHealthierTeeth

“Personalize Your Plate” is the theme for this year's National Nutrition Month in March, sponsored by the Academy of Nutrition and Dietetics. It means there isn't a single diet for all of us: We're each unique with differing body types and tastes, and our diets need to be unique as well. Still, though, you'll want to be sure to include basic nutrients that are generally good for all of us—including for our teeth.

As you “personalize” your daily diet, be sure it includes dental-friendly vitamins and minerals. Here are some of the more important ones that contribute to strong and healthy teeth, and the kinds of foods in which you'll find them.

Vitamin D. This vitamin is a key element for growing and maintaining healthy teeth and bone, mainly by helping the body absorb calcium. You'll find vitamin D in milk, eggs or fatty fish—and you'll also gain a little strolling outdoors in the sunshine!

Vitamin E. As an antioxidant, vitamin E helps the body fight free radical molecules that contribute to cancer development, including oral cancer. You'll find vitamin E naturally in seeds and nuts (and derivative cooking oils), wheat germ and whole grains.

Calcium. When included with vitamin D and phosphorus, calcium is an important “construction material” for building strong teeth and bones. You'll find calcium in dairy products like milk and cheese as well as greens, legumes and tofu.

Phosphorus. Eighty-five percent of the body's phosphorus, a companion mineral to calcium, is found in teeth and bones, where it helps to keep them strong and healthy. You'll find this important mineral in meats, milk and eggs.

Magnesium. This mineral helps mineralize teeth and bones, giving them strength and protection against disease. You can get magnesium by eating nuts, legumes, whole grains, dark leafy greens, seafood and—if you limit the added sugar content—chocolate.

Fluoride. Most people are familiar with fluoride added to drinking water or toothpaste to strengthen tooth enamel against tooth decay, but the mineral also occurs naturally in some foods. You can obtain low amounts of fluoride in seafood and black or green tea.

One last thing! While we're promoting foods that you should eat for healthier teeth, there's also one you'll want to cut back on: processed sugar. This carbohydrate is a major factor in oral bacterial growth that causes tooth decay and gum disease. So, eating foods low in sugar and high in these key vitamins and minerals will help ensure your teeth stay healthy.

If you would like more information about the importance of nutrition in dental care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Nutrition: Its Role in General & Oral Health.”


TakeItFromTaylorSwift-LosingYourOrthodonticRetainerisNoFun

For nearly two decades, singer-songwriter Taylor Swift has dominated the pop and country charts. In December she launched her ninth studio album, called evermore, and in January she delighted fans by releasing two bonus tracks. And although her immense fame earns her plenty of celebrity gossip coverage, she's managed to avoid scandals that plague other superstars. She did, however, run into a bit of trouble a few years ago—and there's video to prove it. It seems Taylor once had a bad habit of losing her orthodontic retainer on the road.

She's not alone! Anyone who's had to wear a retainer knows how easy it is to misplace one. No, you won't need rehab—although you might get a mild scolding from your dentist like Taylor did in her tongue-in-cheek YouTube video. You do, though, face a bigger problem if you don't replace it: Not wearing a retainer could undo all the time and effort it took to acquire that straight, beautiful smile. That's because the same natural mechanism that makes moving teeth orthodontically possible can also work in reverse once the braces or clear aligners are removed and no longer exerting pressure on the teeth. Without that pressure, the ligaments that hold your teeth in place can “remember” where the teeth were originally and gradually move them back.

A retainer prevents this by applying just enough pressure to keep or “retain” the teeth in their new position. And it's really not the end of the world if you lose or break your retainer. You can have it replaced with a new one, but that's an unwelcome, added expense.

You do have another option other than the removable (and easily misplaced) kind: a bonded retainer, a thin wire bonded to the back of the teeth. You can't lose it because it's always with you—fixed in place until the orthodontist removes it. And because it's hidden behind the teeth, no one but you and your orthodontist need to know you're wearing it—something you can't always say about a removable one.

Bonded retainers do have a few disadvantages. The wire can feel odd to your tongue and may take a little time to get used to it. It can make flossing difficult, which can increase the risk of dental disease. However, interdental floss picks can help here.  And although you can't lose it, a bonded retainer can break if it encounters too much biting force—although that's rare.

Your choice of bonded or removable retainer depends mainly on your individual situation and what your orthodontist recommends. But, if losing a retainer is a concern, a bonded retainer may be the way to go. And take if from Taylor: It's better to keep your retainer than to lose it.

If you would like more information about protecting your smile after orthodontics, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”