Starting in the early 1970’s, medication has been used to reduce the breaking down of bone diseases like metastatic bone cancer and osteoporosis. The most common of these medications are known as bisphosphonates which help to slow down the function of osteoclast cells. There are many names for the drugs under this category, and most of them are taken in pill form.

In a healthy body, osteoclasts digest mature bone when required to extract calcium from the bones when the body needs it. Also, it promotes body growth by getting rid of dead bone. Osteoclasts send out chemical messengers to another cell called osteoblasts to produce a new bone. The process aids in growth and healing throughout life, this is known as remodeling.

In some categories of bone disease, the osteoclasts break down and rebuild bone faster than the osteoblasts. The purpose of bisphosphonate medications is to re-build the balance between osteoclasts and osteoblasts. Also, they reduce the pain and suffering that comes from the catastrophic fractures of the hip, wrist, and spine. The medication helps to treat osteoporosis by reducing the high levels of calcium in the blood which can develop in people who have metastatic bone cancer. Although the therapeutic dosages of medications can be prescribed, it is not possible to prescribe bisphosphonate medications to reset the harmony of bone remodeling that exists in a healthy individual.

As with all medications, side effects are expected. Regarding bisphosphonate medications, it is not common, but there is a serious side effect that has been found called bisphosphonate-related osteonecrosis of the jaw after dental implant placement or dental extractions. However, osteonecrosis can lead to the death of bone in a localized size which may or may not become infected. The main concern is that the treatment is unpredictable, usually painful and disfiguring, and treating of bisphosphonate-related osteonecrosis may not be possible.

Due to the extremely rare side effect, the treatment can significantly reduce the quality of life of people suffering from it. Dentists are more concerned about not extracting teeth in individuals that use bisphosphonate medication. This has drastically affected the way dentists prescribe medications for this group of people. For instance, performing root canal therapy on broken roots at the gum line is a wise treatment over extraction in these patients. Just like other treatments, it is good to discuss with both Dr. Gradeless and your physician openly.

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