From Volume 43, Issue 3, April 2016 | Pages 235-242
This report provides important background information on osteoporosis (OP) and bone complications of cancer for the dental team, and discusses why bisphosphonate (BP) therapy is vital for patients with the two conditions. It also addresses several questions, including in particular: ‘Is withholding BP therapy the best way to prevent osteonecrosis of the jaw (ONJ) occurrence?’ Also, ‘Of the two, which is more important: ONJ or OP fracture prevention?’
Thinning of bones is commonly referred to as osteopenia. It is a manifestation of bone physiology permanently deranged by the menopause. Conventionally, once the breakage of bone occurs, the condition is referred to as osteoporosis (OP). OP fractures occur in 1 in 2 women and 1 in 5 men over the age of 50.1 Bone fractures lead to disability and pain. They also cause significant morbidity and mortality and cost the NHS £2.3 billion annually. This does not take into account the enormous costs in terms of reduction in QOL, and loss of independence (particularly after a hip fracture).
First line treatment consists of the oral BPs. They significantly reduce the risk of fracture occurring at all the three common sites namely, the forearm, spine and hip, and offer the promise of a fracture-free life.
However, BP therapy is associated with the risk of ONJ and this continues to remain a source of great concern to the dental team.
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