Journal
JOURNAL OF THE AMERICAN DENTAL ASSOCIATION
Volume 139, Issue 5, Pages 545-552Publisher
AMER DENTAL ASSOC
DOI: 10.14219/jada.archive.2008.0214
Keywords
aging; his phosphonate-associated osteonecrosis; bone loss; decision making; dental care for chronically ill patients; dental care for elderly patients; drug therapy
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Background. Osteoporosis is a common disease disease in middle-aged and older-Americans. The risk of sustaining fractures is a concern and mortality rates C after hip or vertebral fractures are high. Oral health maintenance for adults with osteoporosis is important. Types off Studies Reviewed. The authors conducted a MEDLINE search of the medical and dental literature with the objective of reviewing osteoporosis, its effect on public health in the population in the United States and the implications in providing dental care for these patients. They selected studies by performing a content search with National Library of Medicine medical, subject headings (epidemiology, public health impact, treatment, Adverse drug reactions, cost-effectiveness of osteoporosis therapy, oral health, periodontal disease, adverse drug reactions, bisphosphonates and osteonecrosis of the jaw). They then performed a study design search with a filter so that only randomized clinical trials were included. Results. Osteoporosis and related fractures are more common than coronary disease, stroke and breast cancer. Fractures resulting from osteoporosis can affect a patient's quality of life severely, and fractures result in functional impairment and-increased health care cost and mortality. Medical management of osteoporosis includes diet control, with appropriate intake of calcium and vitamin D, weight-bearing exercise, discontinuation of tobacco and alcohol intake, and use of medications, including selective estrogen receptor modulators, calcitonin, anabolic agents and bisphosphohates. Bisphosphonates have been associated with the development of osteonecrosis of the jaws. Clinical Implications. Oral health maintenance is important in patients with osteoporosis. Bisphosphonate therapy or other medical treatment for these people should be discontinued only after consultation with the patient's physician.
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