HJAR Sep/Oct 2020

HEALTHCARE JOURNAL OF ARKANSAS I  SEP / OCT 2020 43 Niki Carter, DMD Dental Director Delta Dental of Arkansas Many liquid medications for children are high in sugar content, and parents need to be especially mindful of this fact. Adults should also be aware that many vitamins designed to dissolve in the mouth can pro- mote a pH which is more acidic, thus pro- ducing a bacterial environment 5 . The bisphosphonate class of drugs has a huge impact on oral health. These drugs are commonly prescribed to treat osteoporosis and several types of cancers, including mul- tiple myeloma, breast, and prostate cancers 6 . These drugs are prescribed to aid in prevent- ing bone fractures, and also to prevent the spread of cancers to bones. These drugs can come in oral, injection, or infusion form. It is essential for patients to inform their den- tal professionals that they are taking these medications. It is also key for physicians to inform these patients of the oral side effects. Bisphosphonate drugs are excellent for assisting in preventing fractures, but if den- tal surgery is needed after this drug has been taken, it can have significant implications. The drug’s action on osteoclast cells impairs bone healing and remodeling, and increases risk of development of osteonecrosis of the jaw. Osteonecrosis is bone death, which re- sults from loss of blood supply to the bone. Basically, the osteoclasts’ inhibition results in these cells being unable to be resorbed during the normal healing phase, and the jaw bone dies due to the lack of blood sup- ply in the area 6 . This was discovered several years ago, and before this fact was known, many patients lost a good portion of their jaw, depending on the surgery involvement of the jaw bone, and the amount of this drug in their system. The good news is that this fact is now known by most healthcare pro- viders who prescribe and treat patients tak- ing bisphophonates. It is recommended that a drug “holiday” be taken to rid the drug in the patient’s system if dental surgery is warranted. It is