JAW DEATH---something you don’t want to get

Posted by Dr. Edward Magida | Filed under , , , , ,

Many women, as they age, develop post menopausal osteoporosis. This is a condition characterized by a decrease in bone mass and density. As a result of this condition, their bones become fragile and break more easily. In order to prevent this chain of events from happening, doctors prescribe a class of drug known as biphosphonates, and the most popular oral version is called Fosamax. It is actually the 13th most prescribed drug in the U.S. The way the drug works is by altering the way the bone cells make new bone. While the drug helps prevent fractures in the spine or the hip, which could be devastating, it apparently causes problems in the jawbones.  There is the possibility of inhibiting new blood vessel formation, which can interfere with healing after the extraction of a tooth. Some patients, after an extraction, do not heal. Exposed bone is the result of the extraction and this can become infected and very painful and there is no way to treat the problem. The technical term for the problem is called osteonecrosis.

The popular name given to the problem is called jaw death. Most cases of jaw death have occurred in cancer patients who have taken intravenous bisphosphonates, which is one of the drugs given to cancer patients to reduce the incidence of cancer induced bone fractures. There needs to be more research done about whether the oral versions of the drug have the same incidence of problems. What this means is that any person who will be going on the drug needs to have a thorough clinical and radiological (xray) examination done of their teeth and mouth before they are started on the drug. If any dental treatment such as extractions or dental implants are needed, these should be accomplished before the drug regimen is begun. Routine cleanings, fillings root canals and crowns do not cause the associated problems. As to why the jawbone responds negatively to this drug, no one is really sure. So if you are taking this type of drug, please be sure to tell your dentist before treatment is started.

Dental Implants: An amazing alternative to dentures

Posted by Dr. Edward Magida | Filed under , , , , , ,

Mention the word implants and you may notice some eyebrows rise. Mention the words dental implants and you will notice some cringing.

I must say that as a practicing dentist with almost 20 years experience, that dental implants, where appropriate, are truly phenomenal. Whether it is a single tooth implant used to fill the space occupied a long time ago by another tooth, or a full set of teeth supported by implants, this type of treatment is becoming more and more common every day.

An implant is a metal cylinder made out of surgical grade titanium, called a fixture. The implant takes the place of your own natural tooth root. On to this implant, or a number of implants, the dentist attaches prosthetic teeth, which look and feel like your own.

The dentist, usually a periodontist or an oral surgeon, places the implant in a hole carefully drilled into the jawbone. This procedure is done with the patient fully anesthetized, but after the numbness goes away the patient may need pain medication for the next day or so.

After the implant is placed, the gum is replaced over the hole and the implant is allowed to heal and adhere to the bone. The process is called osseointegration. During this period the bone cells actually grow into little pores made in the implant. As the new bone matures and hardens, it locks the implant in place, making it rock solid. It is because this osseointegration process takes place that the use of implants is so predictable and such a successful treatment alternative.

Before a person is selected as a candidate for implants, the dental surgeon must do some measuring. Bone height and width are measured to see if enough is present to support the implant. If not enough bone is present, sometimes the bone can be increased to provide proper anchorage for the implant. This careful examination is done on a case by case basis. Just because your Aunt Becky had implants does not mean you can too. Sometimes implants cannot be placed because the density of the bone is not good. Another reason implants are not possible is because the person needs them in the upper jaw, but the person's sinus is in the way. In general however, most people can have implants placed. In some cases they can truly change a person's life for the better.

If you are tired of wearing dentures, have a missing tooth or teeth that you want replaced, or are facing the prospect of losing a tooth in the near future, you owe it to yourself to investigate this amazing treatment.