Updating your dental professional on changes in your medical history at every dental visit may help to ensure medications you are taking such as bisphosphonates don’t interfere with your treatment results, or cause post-treatment complications.

Bisphosphonates, also known as bone-sparing drugs, are commonly used in tablet form to prevent and treat osteoporosis in postmenopausal women.  Tablet form bisphosphonates are often called “oral bisphosphonates.”  Other forms administered intravenously (IV) are commonly used in the management of advanced cancers that have metastasized to the bone, where the disease often causes bone pain and possibly even fractures. Some common names for oral bisphosphonates include: Fosamax, Boniva, Didrocal, and  Actonel*.  Common names for IV bisphosphonates include Bonefos, Zometa, and Aredia*.

In rare instances, some people being treated with intravenous bisphosphonates have developed a condition called osteonecrosis of the jaw (ONJ).  This condition can be worsened by invasive dental procedures such as dental implants or tooth extractions and can cause severe, irreversible and often debiltating damage to the jaw.  In the early stages of ONJ, people may not have symptoms but as the disease progresses, pain can gradually develop.  The period of time between the first symptoms may be different for each person, but it typically ranges from several months to more than a year.  Some of the symptoms include:

  • Loose teeth
  • Numbness or a feeling of heaviness in the jaw
  • Pain, swelling, or infection of the gums or jaw
  • Gums that are not healing
  • Drainage

Currently, there is not a treatment that definitely cures ONJ; however, nonsurgical treatments such as antibiotics and anti-inflammatory drugs may be may help relieve pain in the short term. Most people diagnosed with ONJ usually need surgery.

If you are taking bisphosphonates and are going to be receiving periodontal surgery or other procedures, your dental professional may recommend you interrupt your bisphosphonate therapy for a period of time prior to, during, and after surgery.

There have be other risk factors associated with ONJ such as age, gender and other medical conditions, so it is important to maintain good oral hygiene and properly fill out your medical history form for your dental professional.

*Inclusion of product names in this patient education material is not intended to imply endorsement by the American Academy of Periodontology.

Filling out Your Medical History Form

Filling out your medical history form at your dental professional’s office is an important way to communicate your overall health with your dental professional. You need to be sure to include any medical conditions you currently have or are pre-disposed to having because of a family history.  There are many systemic diseases associated with periodontal disease, such as diabetes and heart disease, so it will be important to alert your dental professional to these conditions, as this information will be helpful when creating a treatment plan for you.

In addition, be sure to list each medication that you are taking as well as the prescribed dosage, on your health history form.  Many of the common drugs that are prescribed for day-to-day use can have serious side effects on your oral health.  Some of the side effects may include:

  • Dry mouth
  • Xerostomia
  • Gingival enlargement
  • Tooth decay

Recently the use of natural products to prevent disease and manage health conditions has become more popular.  Many of these natural products may have the potential to complicate periodontal treatment, so it is important to include these on your medical history form, as well.  If you have any questions on whether you should include something on the form or not be sure to consult with your dental professional.  Working together, you can both ensure a healthy mouth and body.