Bisphosphonates and Dental Procedures: Why They May Be Contraindicated

Introduction

Bisphosphonates are widely prescribed medications used to treat osteoporosis, bone metastases, and certain cancers. While effective in strengthening bones, they come with unique dental considerations. If you are taking bisphosphonates, your dentist may recommend avoiding or delaying certain dental procedures, especially extractions and implants. But why is that? Let’s break it down.

What Are Bisphosphonates?

Bisphosphonates are drugs that slow down bone resorption, meaning they help prevent bone breakdown. Commonly prescribed bisphosphonates include:

• Alendronate (Fosamax)

• Risedronate (Actonel)

• Ibandronate (Boniva)

• Zoledronic acid (Zometa, Reclast)

They are especially helpful in conditions like:

• Osteoporosis

• Paget’s disease of bone

• Multiple myeloma

• Metastatic cancers to bone

Why Are Bisphosphonates a Concern in Dentistry?

The main risk lies in a condition called Medication-Related Osteonecrosis of the Jaw (MRONJ). This occurs when jawbone tissue fails to heal properly after trauma, leading to bone exposure and necrosis (bone death).

High-risk dental procedures include:

• Tooth extractions

• Dental implants

• Periodontal surgery

• Jaw surgery

Even minor trauma, such as ill-fitting dentures, can sometimes trigger MRONJ.

Who Is at Risk?

Not every patient on bisphosphonates will develop MRONJ, but certain factors increase risk:

• Long-term bisphosphonate use

• Intravenous (IV) administration (higher risk than oral)

• Cancer patients on high-dose therapy

• Concurrent steroid use

• Poor oral hygiene

Dental Management for Patients on Bisphosphonates

Dentists take special precautions when treating patients on bisphosphonates:

1. Medical history review – Always inform your dentist about your medications.

2. Preventive care – Focus on regular checkups, cleanings, and good oral hygiene to minimize invasive procedures.

3. Conservative treatment – If possible, dentists may choose root canal treatment over extraction.

4. Collaboration with physician – In some cases, doctors and dentists may discuss a “drug holiday” (temporary discontinuation), though this remains controversial.

What Patients Should Do

• Tell your dentist and oral surgeon if you are on bisphosphonates.

• Maintain excellent oral hygiene.

• Schedule regular dental checkups to catch problems early.

• Avoid delaying necessary dental work—address dental issues before starting bisphosphonate therapy, if possible.

Key Takeaway

Bisphosphonates are powerful medications that protect bone health, but they pose unique challenges for dental procedures. The risk of osteonecrosis of the jaw makes preventive care and open communication between patients, dentists, and physicians essential.

If you are on bisphosphonate therapy, talk to your dentist about the safest treatment plan for your oral health.

TMJ Dysfunction: How Jaw Pain Can Affect Your Whole Body

TMJ dysfunction, also known as temporomandibular joint disorder, occurs when the joints connecting your jaw to your skull are misaligned, inflamed, or not functioning properly. While it often causes jaw pain and difficulty chewing, TMJ dysfunction can have far-reaching effects on your overall health.

What Is TMJ Dysfunction?

The temporomandibular joint (TMJ) acts like a hinge, allowing your jaw to open, close, and move side-to-side. Dysfunction arises when the joint, muscles, or surrounding tissues are stressed, damaged, or misaligned. Causes include:

• Teeth grinding or clenching (bruxism)

• Poor bite alignment

• Stress and muscle tension

• Trauma or injury to the jaw

• Arthritis affecting the joint

Common Symptoms of TMJ Dysfunction

Adults with TMJ dysfunction may experience:

• Jaw pain or tenderness

• Clicking, popping, or grating sounds in the jaw

• Difficulty or discomfort chewing

• Headaches or migraines

• Ear pain or ringing (tinnitus)

• Neck, shoulder, or upper back pain

How TMJ Dysfunction Affects the Whole Body

TMJ dysfunction doesn’t just cause jaw pain — it can impact your entire musculoskeletal system and overall well-being:

1. Head and Neck – Tension can lead to chronic headaches, migraines, and neck stiffness.

2. Spine and Posture – Misalignment in the jaw can affect head posture, causing shoulder and back strain.

3. Sleep – TMJ issues can worsen sleep quality, especially if linked to teeth grinding or sleep apnea.

4. Nervous System – Chronic jaw tension can increase stress and fatigue.

5. Digestive System – Difficulty chewing may affect proper digestion and nutrition.

Treatment Options for TMJ Dysfunction

• Pain Management – Anti-inflammatory medications or muscle relaxants

• Physical Therapy – Exercises to strengthen jaw muscles and improve movement

• Dental Treatments – Bite guards, occlusal adjustments, or orthodontic corrections

• Stress Reduction – Relaxation techniques to reduce jaw clenching

• Surgical Options – In severe cases, minimally invasive TMJ surgery

Early intervention can prevent complications and improve overall quality of life.

Why Choose Pain Free Dentist Sydney

At Pain Free Dentist Sydney, we provide expert diagnosis and treatment for TMJ dysfunction, addressing not only jaw pain but its effects on your entire body. Our gentle, modern approach helps restore jaw function and overall health.

📞 Call 9558 8988
📧 Email: info@painfreedentistsydney.com.au
🌐 Visit: https://painfreedentistsydney.com.au/

Adult Tongue Tie: What You Need to Know

A tongue tie, also known as ankyloglossia, is a condition where the tissue connecting the tongue to the floor of the mouth is unusually short or tight. While often diagnosed in children, many adults also live with tongue tie, which can affect speech, oral hygiene, and overall oral function.

What Is Adult Tongue Tie?

Adult tongue tie occurs when the lingual frenulum (the thin band of tissue under the tongue) restricts tongue movement. Unlike in children, where the focus is often breastfeeding, adult tongue tie can impact:

• Speaking clearly

• Swallowing comfortably

• Cleaning the mouth properly

• Oral posture and jaw function

Symptoms of Adult Tongue Tie

Adults with tongue tie may notice:

• Difficulty sticking out the tongue past the teeth

• Trouble pronouncing certain sounds (like “t,” “d,” “l,” and “r”)

• Discomfort or pain under the tongue

• Receding gums or tooth wear from tongue pressure

• Challenges with oral hygiene due to limited tongue mobility

Causes of Tongue Tie

Tongue tie is usually congenital, meaning it’s present from birth. It may go unnoticed during childhood if symptoms are mild. In adults, issues often arise due to:

• Speech or pronunciation challenges

• Compensatory oral habits

• Jaw pain or TMJ problems

• Ongoing oral hygiene issues

Treatment Options for Adult Tongue Tie

1. Frenectomy / Frenuloplasty – A minor surgical procedure to release the tight frenulum

2. Laser Tongue Tie Release – A minimally invasive option with faster healing

3. Speech Therapy – Helps improve articulation and tongue function post-treatment

4. Oral Exercises – Strengthen tongue mobility and oral function

Treatment is generally safe, quick, and can greatly improve quality of life.

Benefits of Tongue Tie Treatment

• Improved speech clarity and pronunciation

• Better oral hygiene and easier cleaning

• Reduced strain on jaw and teeth

• Enhanced eating, swallowing, and overall oral comfort

• Increased confidence and quality of life

Why Choose Pain Free Dentist Sydney

At Pain Free Dentist Sydney, we specialize in gentle, effective treatment for adult tongue tie. Our experienced team provides personalized care, using advanced techniques to ensure comfort and optimal results.

📞 Call 9558 8988
📧 Email: info@painfreedentistsydney.com.au
🌐 Visit: https://painfreedentistsydney.com.au/