Metal Mouth Message Board

I saw that there had been a question on this earlier, but I didn't see any responses to it. If someone has low bone density (osteoporosis or osteopenia), will this impact how well braces will work or how long it might take for teeth to get settled back in and stable? Will this impact how successful dental implants will be? Should I be taking even more extra calcium?

Neither my implant doc nor my orthodontist ever asked me about osteoporosis - should they be asking adult patients about this as part of an initial screening?

I'm 29 and I have osteoporosis (diagnosed at age 25) and I also have braces. I'm up for jaw surgery sometime next year. I'm on once a week Fosamax which has helped me gain some bone. Interesting question and not easily addressed. (In fact I think it's my post you saw before).

I've been told it's not a factor in what I'm about to have done to my upper and lower jaws, and my braces have been ok. Osteoporosis levels are really only measured in the hips and spine and I have it in both. Like I said, I've gained some bone with the Fosamax and I've been taking the amount of calcium recommended to me by my doctor (1500 mg daily). I'm confident that I'll be OK. Oh, yes, and weight bearing exercise (cardiovascular, using light weights) has also helped tremendously.

Hope this helps.
~Joanne

I don't know about dental implants per se, but I've always written in "osteoporosis" when filling out new patient forms. I do encourage you to ask your doctor(s) any questions you may have and bring up topics that concern you even when not asked for the information.
~Joanne

Those were very thoughtful responses. I'm embarassed to admit that I hadn't thought very much about offering the information, rather than waiting for the ortho to ask about it!

It was a long time before I began asking and informing the doctors of what concerned me, but it was mostly so all my doctors would be on the same page as me. I write my questions down before I go into the appointment, which helps a lot. Really helps with any "white coat phobias" I may have too!

Hi,
I'd still like to see an opinion from one of the doctors on this topic. Interestingly enough, in the discussion on how braces work, there is a lot of talk about osteoclasts and osteoblasts. I tried Googling those terms and I found references to osteoporosis - there was some stuff about the osteoclasts and osteoblasts being out of balance.

Well, if osteoporosis means the osteoclasts and osteoblasts are out of balance, and those are a basis for how braces work, does that mean that braces don't/won't work as well or on the time frame if you have osteoporosis.

P.S. Where would we be without Google. Isn't it amazing how much you can find out, for better or for worse, just by typing in a phrase?

It is very important that you talk to your dentist, orthodontist and/or primary care physician if you are taking Fosamax (which I do, 70mg 1xwk) or any of the bisphosphonates and need to have a tooth extraction, implant, etc. There is evidence that folks taking these drugs could be at signicant risk for a serious jaw disease (osteonecrosis -- You can do a Google search and find more info.) I was to have 4 teeth extracted as part of the plan for straightening my teeth, but the dentist who was to do the extractions had just learned of the research so the decision was made not to proceed. Three of the 4 teeth have moved into position. One is a real problem and now my orthodontist is researching what the next step will be. It is discouraging and I have been considering having the braces removed. (It was the awkward position of that 4th tooth that made me decide to get braces in the first place.)

The problem seems to be much more significant among those receiving high doses of the bisphosphonates intravenously as an adjunct treatment for cancer. But they are being watchful.

If anyone knows more about this, please post info and updates!

Wow! Well, you certainly got my attention on this. I have osteopenia and take calcium supplements at this time, not anything else. But, I will be talking to my ortho, my implant specialist and my dentist about this. My dentist is the husband of a friend of mine - and she has implants.

Thanks you!

Hi,

From what I understand, it is only if you take the bisphosphonates that you need be concerned, but best you check and let us know if anything has changed on that. The Fosamax did correct my osteopenea, but who would have thought it would raise these concerns!

All the best.

Wow, this is news to me, as well. There is always something new to learn.

I did some research and found these articles and links:

http://www.ada.org/prof/resources/topic ... crosis.asp

http://www.annalsmed.org/pdf200409/V33N4p48S.pdf (requires Acrobat Reader)

http://www.usatoday.com/news/health/200 ... aths_x.htm

http://www.cancerhelp.org.uk/help/defau ... page=16003

http://www.mja.com.au/public/issues/182 ... 44_fm.html

http://flapsblog.com/?cat=40

http://www.virginia-injury-attorneys.co ... nd-fos.cfm




I hope this helps you guys.

Thank you for your research. I have been agonizing over this since October. I will advise of any news from my docs as to the next step with my own treatment. By the way I am 56 going on 34 ;-)

Betty Bat wrote: Neither my implant doc nor my orthodontist ever asked me about osteoporosis - should they be asking adult patients about this as part of an initial screening?

You know, this is an interesting question. Osteoporosis can occur at young ages, for instance if a woman had a hysterectomy in her early 20s, her bone density could suffer (this happened to one of my friends). Who would think of asking a 25-year-old if she has osteoporosis?!

Perhaps orthodontists and oral surgeons should ask. Regardless, I think it's always a good idea to openly tell your docs about your health problems, even if they don't ask you, or even if you think it might not be related. I always say that we, as patients, must be advocates for ourselves. We must do everything to understand the ins and outs of our health problems and protect ourselves from sloppy medicine and mistakes. I have thyroid disease and I always mention it, because some meds and even foods can interfere with the absorption of the thyroid medicine I take every day. It's always better to err on the side of safety in that respect, IMO.

Here is a site that seems to have new info for anyone concerned about bone deterioration and implants:

http://www.osteohealth.com/

I would pass this info along to caregivers.

Wire Weary wrote:It is very important that you talk to your dentist, orthodontist and/or primary care physician if you are taking Fosamax (which I do, 70mg 1xwk) or any of the bisphosphonates and need to have a tooth extraction, implant, etc. There is evidence that folks taking these drugs could be at signicant risk for a serious jaw disease (osteonecrosis -- You can do a Google search and find more info.) I was to have 4 teeth extracted as part of the plan for straightening my teeth, but the dentist who was to do the extractions had just learned of the research so the decision was made not to proceed. Three of the 4 teeth have moved into position. One is a real problem and now my orthodontist is researching what the next step will be. It is discouraging and I have been considering having the braces removed. (It was the awkward position of that 4th tooth that made me decide to get braces in the first place.)

The problem seems to be much more significant among those receiving high doses of the bisphosphonates intravenously as an adjunct treatment for cancer. But they are being watchful.

If anyone knows more about this, please post info and updates!

Wow, that's quite a revelation. I'm sorry that this happened to you, but it's good that your doc is being careful. I wonder if Damon brackets could be helpful in your case? In crowded cases where they recommend extractions, supposedly the Damon brackets help to grow bone. I don't know if the drug/damage issues would play a role in this. If you want, I can contact somebody at Ormco and ask about it.

I am wearing Damon braces. The tooth in question is located outside the tooth line (tech jargon, not) just inside the roof of my mouth. There is hardly any space between the teeth where it should fit in. I have been in braces since 11:45am on Sept. 28th (but who's counting) and I had the wires changed this past week. Hopefully there will be some movement to let that tooth in, but so far no change. And believe me, I'm watching. My doc mentioned a soft tissue extraction, which is a bit complicated to explain and I'm not really sure I understand it. But "guinea pig" keeps flashing in front of me.

Thanks again!