If you are considering dental implants, but you’re on bisphosphonates, you might have heard that you need to go on a drug holiday to protect yourself from a rare but potentially serious complication: osteonecrosis of the jaw. However, there’s no evidence to support the concept of a drug holiday for what remains a very rare complication.
What Is Osteonecrosis of the Jaw?
Osteonecrosis of the jaw is a complication of oral surgery in which the jawbone begins to die. We talk about it in relation to dental implants, but it also occurs in relation to other oral surgery, such as simple tooth extraction. In fact, it isn’t just related to surgery, either. A recent study found that more cases of osteonecrosis were linked to poor denture fit than to dental implants, though the risk was higher in people who had an invasive oral procedure. Osteonecrosis usually won’t cause complete destruction of the jaw, but it can cause significant loss of jawbone to the point of losing dental implants and even visible deformity. It can be painful and debilitating. So it’s a complication that we want to avoid.
How Common Is Osteonecrosis of the Jaw?
As we said above, this is a rare complication. The rates are relatively low, though they increase based on many factors. The risk for people taking oral bisphosphonates is about 0.1% (1 in 1000) for people taking oral bisphosphonates or 0.2% for people who have been taking them for more than 4 years.
Other factors may have an impact. If your jaw has been exposed to radiation as part of cancer treatment, your risk may be much higher.
Why Not a Drug Holiday?
If using these medications can increase your risk of these complications, why not institute a drug holiday and stop taking the osteoporosis medication?
Because it probably doesn’t help. While some people think it works, there isn’t any evidence that it does reduce the risk. A number of studies have tested it, but the results have been inconclusive. On the other hand, we do know that stopping medication could potentially have negative effects. So why introduce a new risk when you won’t necessarily reduce your other risks?
Preventive Treatment Reduces Risk
While you won’t necessarily benefit from a drug holiday, there are other things we can do to help you avoid this complication. One is to treat ongoing gum disease before you get implants. People with gum disease may be more likely to develop osteonecrosis. With good prevention measures, we might be able to reduce your risk of this complication by as much as two-thirds!
The Benefits of Dental Implants Outweigh Risks
It’s easy to start getting paranoid about rare complications when you’re considering a medical procedure. We want to remind you again: this complication is rare. And not getting dental implants doesn’t protect you. Remember: more people with dentures got the condition than those with dental implants. And think of the benefits you are receiving in exchange for a small risk: replacement teeth that are almost exactly like natural teeth. You’ll be able to bite and chew normally and smile and speak with confidence. It’s worth it.
Do you want to talk about dental implants in Rochester, MI? We can answer all your questions to help you understand the risks and benefits so you can make the right decision for you.