Osteoporosis Risks in Dental Surgery for Seniors

Q: Osteoporosis Risks in Dental Surgery for Seniors

Hello Lisa： The medications used for osteoporosis, whether oral or injectable, can suppress the new bone metabolism over time, leading to bones filled with old bone tissue. <br>If a patient undergoes dental surgery, this may result in osteonecrosis or delayed wound healing. <br>I

Osteoporosis and its Risks in Dental Surgery

Hello Doctor, my mother, who is about 64 years old, had her teeth extracted due to severe decay and wishes to get a full set of dentures.
Six months ago, during a follow-up visit, the doctor mentioned that there was bone growth in the extraction site that could interfere with the dentures.
He advised her to undergo surgery at a major hospital's oral surgery department before proceeding with the dentures.
However, after an X-ray at the hospital, the surgeon was reluctant to perform the surgery due to my mother's osteoporosis, citing risks.
When she inquired about the specific risks, the doctor was unwilling to discuss them and simply stated that if it wasn't causing any issues, it could be left alone.
Recently, the area of bone overgrowth has become swollen and is showing signs of infection, with sores developing in her mouth, making it uncomfortable for her to eat.
Could you please explain the impact of osteoporosis on dental health? Is it possible for a general dentist to perform the surgery? This situation is quite distressing.
Thank you.

Lisa, 30~39 year old female. Ask Date: 2021/01/31

Dr. Zeng Guanghui reply Dentistry

Hello Lisa: The medications used for osteoporosis, whether oral or injectable, can suppress the new bone metabolism over time, leading to bones filled with old bone tissue.
If a patient undergoes dental surgery, this may result in osteonecrosis or delayed wound healing.
It is advisable to consult an oral surgeon at a medical center to evaluate the suitability for oral surgery.
Director Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2021/01/31

More Info

Osteoporosis is a condition characterized by weakened bones, making them more susceptible to fractures and other complications. In the context of dental surgery, particularly for seniors, osteoporosis can significantly influence the risks and outcomes associated with procedures such as tooth extractions and the placement of dental implants or dentures.

When a patient with osteoporosis undergoes dental surgery, several factors come into play. First, the integrity of the jawbone is crucial for successful dental procedures. Osteoporosis can lead to a decrease in bone density, which may compromise the jawbone's ability to support dental implants or withstand the forces exerted during tooth extractions. This can result in complications such as delayed healing, increased risk of infection, and potential for bone fractures during the procedure.

In your mother's case, the dentist's reluctance to perform surgery due to her osteoporosis is understandable. The presence of new bone growth in the extraction site, while a positive sign of healing, can also complicate the fitting of dentures. If the bone is not adequately integrated or if the surrounding tissues are inflamed or infected, it can lead to discomfort and difficulty in wearing dentures. The swelling and potential infection you mentioned indicate that there may be an underlying issue that needs to be addressed before proceeding with any dental work.

The risks associated with dental surgery in patients with osteoporosis include:
1. Delayed Healing: Osteoporotic bones may take longer to heal after surgery, which can prolong recovery times and increase the risk of complications.

2. Infection: Weakened bone and surrounding tissues can be more susceptible to infections, particularly if there are existing issues like swelling or pus formation.

3. Bone Fractures: During surgical procedures, there is a risk that the jawbone may fracture due to its compromised state, leading to further complications.

4. Implant Failure: If dental implants are placed in osteoporotic bone, there is a higher likelihood of implant failure due to inadequate bone support.

Given these risks, it is essential for your mother to consult with a dental specialist who has experience in treating patients with osteoporosis. A thorough evaluation, including imaging studies, can help determine the best course of action. In some cases, medications that promote bone density may be recommended prior to surgery to enhance bone quality.

As for whether general dentists can perform the necessary procedures, it often depends on their training and experience with complex cases. While some general dentists may be equipped to handle straightforward extractions or denture fittings, more complicated situations, especially those involving osteoporosis, are best managed by oral surgeons or specialists in prosthodontics.

In summary, osteoporosis can significantly impact dental surgery risks, particularly in seniors. It is crucial to have open communication with healthcare providers about these risks and to seek specialized care when necessary. Your mother's situation is complex, and addressing the underlying issues, such as the infection and bone growth, should be prioritized before considering further dental work. Seeking a second opinion from a specialist may provide additional options and peace of mind.

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