if i have osteoporosis which is a better course of treatment, have an apico or an extraction

Symptoms

Nonpharmacological management of osteoporosis includes adequate calcium and vitamin D intake, weight-bearing exercise, smoking cessation, limitation of alcohol/caffeine consumption, and fall-prevention techniques. 2 – 6, 9, 18, 34

Causes

While bisphosphonates are recommended as first-line PMO treatment options, the authors note that raloxifene should be considered for younger postmenopausal women with osteoporosis or with low BMD because it prevents bone loss and reduces risk of vertebral fractures. In addition, teriparatide is suggested for those at high risk for fracture.

Prevention

Choosing the Best Doctor to Treat Osteoporosis. For unusual or difficult cases, metabolic bone specialist is often a good choice. However, many metabolic bone specialists have practices in large universities, which may be a little impractical to visit regularly if you are living in rural areas.

Complications

The American College of Physicians (ACP) recently published updated treatment guideline recommendations for men and women with low BMD and osteoporosis. For women, pharmacological treatment with alendronate, risedronate, zoledronic acid, or denosumab for five years is appropriate.

What are the nonpharmacological treatment options for osteoporosis?

Should bisphosphonates be the first-line PMO treatment for osteoporosis?

How to choose the best doctor to treat osteoporosis?

What are the ACP treatment guidelines for osteoporosis and low BMD?

What is the largest complication of teeth extraction in receiving bisphosphonate therapy?

The most common complication in patients on bisphosphonate therapy is osteonecrosis of jaw (ONJ) which can occur after any surgical dental procedure and the risk for the development of osteonecrosis of jaw is higher in patients receiving intravenous bisphosphonate therapy than in patients receiving oral bisphosphonate ...

Can you have a tooth pulled if you are on Prolia?

Dental side effect of receiving Prolia Prolia has a side effect in patients who have to have tooth extractions performed. The trauma of the extraction on the bone surrounding the tooth may lead to a condition where the bone dies off, and following the extraction fragments of dead bone are lost from the extraction site.

How long after Prolia can you have tooth extraction?

For those who stopped denosumab (21/28), 5 waited 1 month before performing dental extraction; 7 waited 2 months, 4 waited 3 months, 4 waited 4 months, and 1 waited 5 months (Fig. 2d). The median time interval was 2 months, and the average 2.47 months.

How long do you have to be off Fosamax before tooth extraction?

These studies also suggest that stopping a bisphosphonate for 3 months prior to a procedure seems to reduce the incidence of osteonecrosis.

Is Prolia the best treatment for osteoporosis?

Clinical trials found Prolia just as effective (but really no more effective) than bisphosphonates, which are the current standard for osteoporosis care.

Is Prolia worth the risks?

Are there any dangers of using this drug? Studies have found that Prolia is generally safe and effective to treat osteoporosis and certain types of bone loss. For example, in the studies, people taking Prolia for up to 8 years didn't have significant side effects compared with people taking a placebo.

How common is osteonecrosis of the jaw with Prolia?

In cancer patients exposed to denosumab, the risk of ONJ varies from 0.7 to 1.9% (70 to 90 cases per 10,000 patients) (3) and they have been reported to have a risk of developing ONJ similar to that of acid zoledronic (10).

Can you have a root canal while taking Prolia?

Neither bisphosphonates nor denosumab drugs enter or become incorporated into the teeth themselves. So treatment such as prophylaxis, restorations, crowns, bridges, nonsurgical root canal treatments, and nonsurgical periodontal treatment that does not place excessive pressure on alveolar ridges is considered safe.

Does Prolia cause weight gain?

Weight gain itself wasn't reported as a side effect during clinical trials of Prolia. However, some people taking Prolia did have swelling in their arms or legs. And with swelling, your body weight can be quickly increased.

How does osteoporosis affect dental treatment?

Osteoporosis impacts all the bones of the body, including the jawbones. Loss of bone density in the jaw compromises tooth stability, increasing the risk of tooth loss and periodontal disease. Osteoporosis affects teeth as well as dental implants, and may limit your dental treatment options.

Does osteoporosis medication affect your teeth?

“The use of bisphosphonates, while excellent to strengthen your bones, can actually negatively influence your dental health,” says Ottawa dentist Dr. Pamela Li. “It can actually lead to something called osteonecrosis of the jaw, which causes serious damage to your jaw bone.”

Are osteoporosis drugs worth the risk?

For Most, Osteoporosis Treatment Benefits Outweigh Risks “When these drugs are used appropriately, they are safe as compared with many other things that we do in medicine. They will provide a lot more benefit than the risks that they pose,” he says.

Which Medications Are Commonly Used For Osteoporosis Treatment?

Bisphosphonates are the most common medications prescribed for osteoporosis treatment. These include: 1. Alendronate (Fosamax) 2. Risedronate (Acto...

How Do Most Osteoporosis Medications Work?

With the exception of teriparatide, osteoporosis medications slow bone breakdown. Healthy bones continuously break down and rebuild.As you age — es...

How Do You Know If You're Taking The Right bisphosphonate?

Drugs in the bisphosphonate class are more alike than they are different. They all help maintain bone density. And, all bisphosphonates have been s...

When Might Other Osteoporosis Medications Be used?

Drugs such as denosumab, teriparatide and abaloparatide can be used by anyone with osteoporosis, but are more likely to be recommended for people w...

What Are Common Side Effects of Bisphosphonate pills?

Bisphosphonate pills aren't absorbed well in the stomach. The main side effects of bisphosphonate pills are stomach upset and heartburn. Generic fo...

Do Intravenous Bisphosphonates Have Advantages Over The Pill form?

Infused forms of bisphosphonates don't cause stomach upset. And it may be easier for some women to schedule a quarterly or yearly infusion than to...

Can Bisphosphonates Hurt Your Bones?

Long-term bisphosphonate therapy has been linked to a rare problem in which the upper thighbone cracks and may break. This injury, known as atypica...

How Long Should You Take A Bisphosphonate For Osteoporosis Treatment?

There's some uncertainty about how long to take bisphosphonates because of a lack of long-term studies. Bisphosphonates have been shown to be safe...

What Happens If You Break A Bone While Taking An Osteoporosis medication?

Osteoporosis medications lower the chance of fracture, but they don't eliminate all risk of breaking a bone. If you have a fracture while on treatm...

Can Medication Alone Successfully Treat Osteoporosis?

Don't rely entirely on medication as the only treatment for your osteoporosis. These practices also are important: 1. Exercise. Weight-bearing phys...

What is the new drug for osteoporosis?

A number of other osteoporosis drugs are in development, including a new monoclonal antibody (romosozumab) and drugs that block sclerostin, a protein that inhibits bone formation. However, Dr. Slovik doesn't think we're going to see any of these new drugs approved within the next year.

How to determine if you have osteoporosis?

Your doctor will determine whether you have osteoporosis by measuring your bone density —usually at the hip and spine—using dual energy x-ray absorptiometry (DEXA).

How does raloxifene work?

It works by binding with estrogen receptors around the body to produce estrogen-like effects, one of which is to decrease bone turnover. "For people with osteoporosis of the spine, raloxifene reduces the risk of vertebral fractures," Dr. Slovik says.

What is raloxifene used for?

Raloxifene (Evista), a selective estrogen receptor modulator (SERM), is perhaps best known for its role in breast cancer prevention and treatment, but it serves double duty in treating osteoporosis, too. It works by binding with estrogen receptors around the body to produce estrogen-like effects, one of which is to decrease bone turnover.

Which is better, alendronate or risedronate?

Alendronate, risedronate, and ibandronate have all been shown effective for reducing spine fractures. For women with a history of hip or nonspinal fractures, alendronate and risedronate are better options than ibandronate.

How long do women take bisphosphonates?

Doctors acknowledge that the risk of these side effects also increases with long-term use of bisphosphonates, so most women take these drugs for about five years. The good news is that the bone-protective benefits continue even after you stop taking bisphosphonates.

How long does it take to sit up after taking bisphosphonate?

If you have gastrointestinal problems like reflux, or if you can't sit or stand upright for the full 30 to 60 minutes required after taking an oral bisphosphonate, then your doctor may put you on an injection or infusion of these drugs, which works about as well as the oral versions.

What is the best treatment for osteoporosis?

If you can't tolerate the more common treatments for osteoporosis — or if they don't work well enough — your doctor might suggest trying: Teriparatide (Forteo). This powerful drug is similar to parathyroid hormone and stimulates new bone growth. It's given by daily injection under the skin.

How to reduce the risk of osteoporosis?

Smoking increases rates of bone loss and the chance of fracture. Avoid excessive alcohol. Consuming more than two alcoholic drinks a day might decrease bone formation.

What is the complication of bisphosphonates and denosumab?

A very rare complication of bisphosphonates and denosumab is a break or crack in the middle of the thighbone. A second rare complication is delayed healing of the jawbone (osteonecrosis of the jaw). This can occur after an invasive dental procedure such as removing a tooth.

How long can you take teriparatide for osteoporosis?

After two years of treatment with teriparatide, another osteoporosis drug is taken to maintain the new bone growth. Abaloparatide (Tymlos) is another drug similar to parathyroid hormone. You can take it for only two years, which will be followed by another osteoporosis medication. Romosozumab (Evenity).

What is the newest bone building medication?

Romosozumab (Evenity). This is the newest bone-building medication to treat osteoporosis. It is given as an injection every month at your doctor's office. It is limited to one year of treatment, followed by other osteoporosis medications.

How often is denosumab shot?

Denosumab is delivered via a shot under the skin every six months. If you take denosumab, you might have to continue to do so indefinitely.

What are the side effects of bisphosphonates?

Examples include: Side effects include nausea, abdominal pain and heartburn-like symptoms. These are less likely to occur if the medicine is taken properly.

Abstract

Approximately 10 million men and women in the U.S. have osteoporosis, 1 a metabolic bone disease characterized by low bone density and deterioration of bone architecture that increase the risk of fractures. 2 Osteoporosis-related fractures can increase pain, disability, nursing home placement, total health care costs, and mortality.

INTRODUCTION

Osteoporosis is a bone disorder that increases a person’s risk of fracture due to low bone mineral density (BMD), impaired bone microarchitecture/mineralization, and/or decreased bone strength.

PATHOPHYSIOLOGY

Bones provide structure for the body, protection for the organs, and storage for minerals, such as calcium and phosphorus, that are essential for bone development and stability. Individuals continue to build bone and will reach peak bone mass at about 30 years of age, after which they begin to lose bone mass steadily.

ETIOLOGY

Primary osteoporosis is often associated with age and sex hormone deficiency. Age-related osteoporosis results from the continuous deterioration of the trabeculae in bone. In addition, the reduction of estrogen production in post menopausal women causes a significant increase in bone loss.

SCREENING AND DIAGNOSIS

Published osteoporosis screening guidelines vary greatly. In general, most organizations recommend that all adults older than 50 years of age with a history of fracture receive BMD screening.

SELECT GUIDELINES AND RECOMMENDATIONS

In a systematic review, Solomon et al. looked at 18 osteoporosis guidelines, among them those of the NOF, the ACR, and the American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE).

NONPHARMACOLOGICAL MANAGEMENT

Nonpharmacological management of osteoporosis includes adequate calcium and vitamin D intake, weight-bearing exercise, smoking cessation, limitation of alcohol/caffeine consumption, and fall-prevention techniques. 2 – 6, 9, 18, 34

What are the best medications for osteoporosis?

There are several types of osteoporosis drugs, which are available by prescription only: 1 Bisphosphonates, such as Fosamax, Boniva, Actonel, and Reclast 2 Calcitonin, sold as Fortical and Miacalcin 3 Hormone therapy, or estrogen 4 SERMS (selective estrogen receptor modulators), such as Evista ( raloxifene) 5 Parathyroid hormone ( Forteo or teriparatide) 6 Prolia, a biologic drug

How many men over 50 have osteoporosis?

Cutting that risk is crucial. About half of women and a quarter of men over age 50 will have an osteoporosis -related fracture, notes the National Osteoporosis Foundation. Fractures most often affect the hip, spine, and wrist, but can affect any bone.

Does Prolia cause low calcium levels?

And the newest osteoporosis drug, Prolia, may cause low blood calcium levels and could increase infection risk, because it targets a chemical in the immune system. As with any drug, you and your doctor need to weigh the risks and benefits. 5.

Can you build bone with drug therapy?

Depending on the state of your bones, "you can build some bone and get out of the osteoporosis range with drug therapy," says Jeri Nieves, PhD, a Columbia University associate professor of clinical epidemiology.

Can you hear osteoporosis?

For many people, hearing "You have osteoporosis" is startling. Some hear it in the hospital after breaking a hip. Others get the news after getting a bone density test. Osteoporosis is most common in women after menopause, people with osteoporosis in their family, and people with a small frame. But others can also get it, raising their risk ...

Can osteoporosis be reversed?

That is, "you can reverse theconsequences of osteoporosis," says Robert Heaney, MD, vice president for research and professor of medicine at Creighton University in Omaha, Neb. A bone biologist, Heaney has spoken for Merck and Amgen. Doing that typically involves being active, getting enough calcium and vitamin D, and taking osteoporosis drugs.

How can osteoporosis be prevented?

Osteoporosis can be prevented. Exercise, especially lifting weights, helps to maintain healthy bone mass. Healthy lifestyle choices, such as not smoking or misusing substances, also decrease your risk for developing osteoporosis.

What is the Chinese medicine of acupuncture?

Acupuncture is a therapy used in traditional Chinese medicine. The practice involves placing very thin needles in strategic points on the body. This method is believed to stimulate various organ and body functions and promote healing. Acupuncture is often combined with herbal therapies.

What is horsetail used for?

Horsetail. Horsetail is a plant with possible medicinal properties. The silicon in horsetail is believed to help with bone loss by stimulating bone regeneration. Although clinical trials to support this assertion are lacking, horsetail is still recommended by some holistic doctors as an osteoporosis treatment.

Does black cohosh help with bone loss?

It contains phytoestrogens (estrogen-like substances) that may help prevent bone loss. A 2008 study. Trusted Source. found that black cohosh promoted bone formation in mice. More scientific research is needed to determine if these results can be extended to treatment in humans with osteoporosis.

Does bisphosphonate cause heartburn?

But all hormone therapy drugs carry side effects that can interfere with other parts of your life. Medications from the bisphosphonate family are also a common treatment option, as they stop bone loss and reduce the risk of fractures. Side effects from this class of medication include nausea and heartburn.

Can you lose bone mass with osteoporosis?

When a person is diagnosed with osteoporosis, they’re advised to change their diet to incorporate more calcium. Though bone mass can’t be instantly corrected, dietary changes may stop you from losing more bone mass. Hormone replacement drugs, particularly ones that contain estrogen, are often prescribed.

Can soy be used for osteoporosis?

Isoflavones are estrogen-like compounds that may help protect bones and stop bone loss. It’s generally recommended that you talk to your doctor before using soy for osteoporosis, especially if you have an increased risk of estrogen-dependent breast cancer .

What is the International Task Force on Osteonecrosis of the Jaw?

In response to concern about jaw necrosis, 14 professional organizations of dentists, physicians, and bone scientists formed the International Task Force on Osteonecrosis of the Jaw. The task force reviewed all the research on that condition published from 2003 to 2014.

How long does bisphosphonate treatment last?

Risk of jaw necrosis and atypical thigh fracture is lower when use of bisphosphonates is limited. For most women, bisphosphonate treatment ends after five years of oral therapy or after three annual intra-venous infusions of zolendronate. However, the drugs' effects remain for several years after therapy is discontinued.

What age should I get a dexa scan?

A DEXA scan is recommended for women ages 65 or older and for women ages 50 or older who have broken a bone recently . (At least 50% of women who have a hip fracture have already broken another bone.) Your doctor may also recommend a DEXA scan if you smoke, consume an average of three or more alcoholic drinks a day, have a low body mass index (BMI), ...

How to reduce risk of tooth loss?

You can further reduce your risk through vigilant dental care. Brush twice a day, floss daily, and have regular dental cleanings. To further minimize risk, choose the least invasive dental procedures possible—a root canal instead of an extraction, or a bridge instead of an implant.

Does zoledronate reduce hip fractures?

For example, taking zoledronate or denosumab can decrease the risk of hip fractures by 40% and spine fractures by about 70% . For women with low bone density, alendronate is associated with a reduction of about 50% for hip and spine fractures and 23% for wrist, ankle, and other bone fractures. (See "Effectiveness of common osteoporosis medications.")

Can you take bisphosphonate with low bone density?

If you have low bone density and are debating whether to take a bisphosphonate, you may consider the following: Osteoporotic fractures can be debilitating. If you accumulate several vertebral fractures, you may lose height, develop a hump, and have less room for your abdominal organs.

Is osteoporosis a common disease?

Osteoporosis is a common disease and fragil ity fractures increase dramatically with age. "The occurrence of a fracture can be devastating, and women can benefit from the effective therapies that markedly reduce their risk of osteoporotic fractures.

What is the best medicine for bone loss?

You can take them as oral tablets, nasal sprays, injections, and intravenous administrations. The most common drugs prescribed are bisphosphonates like alendronate, rised ronate, and zoledronic acid. Other options are estrogen-like medicines, such as denosumab and calcitonin.

How to prevent bone loss?

Your doctor may recommend taking certain medications to prevent or treat bone loss, and some may even help you rebuild bone density. You can also help prevent fractures and other symptoms of osteoporosis with: a nutritious diet. regular exercise. healthy habits.

How to stop bone loss?

You may be able to rely on lifestyle modifications to stop bone loss, like: a healthy, robust, and diverse diet. a regular variety of exercise. supplements, if needed. Your doctor may also recommend taking medications to prevent osteoporosis from developing. A diagnosis of osteoporosis comes when your bone mass is low.

How do you know if you have osteoporosis?

A diagnosis of osteoporosis comes when your bone mass is low. You may find out you have osteoporosis from a bone scan or after you experience a broken bone. Osteoporosis is often a condition associated with aging, and women can be especially vulnerable to it.

What are the complications of osteoporosis?

regular exercise. healthy habits. the use of supplements (possibly) A serious complication of osteoporosis is breaking a bone, which can lead to: chronic pain. limited mobility. a loss of independence. It’s important to avoid falls as much as possible.

How to keep bones strong in adulthood?

Engaging in regular exercise can help your bones stay strong in adulthood. There are additional benefits to exercise like strengthening your muscles to help you stay coordinated and balanced. These benefits can also help you prevent falls or bumps into objects that might lead to broken bones with osteoporosis.

Can you reverse bone loss?

You cannot reverse bone loss on your own. But there are a lot of ways you can stop further bone loss. If you are diagnosed with osteoporosis or at a greater risk for developing it, your doctor may recommend certain medications to take. Your risk for the condition may increase due to:

What kind of doctor treats osteoporosis?

Your primary family doctor can help you choose which one is the best for you: Rheumatologists: They diagnose and treat problems of muscles, joints, and bones, including autoimmune disorders such as lupus.

Who is the first person to diagnose osteoporosis?

A gynecologist or family practitioner is often the first person that diagnoses someone with osteoporosis before providing a recommendation to a specialist. Choosing a doctor to diagnose or treat osteoporosis can be disorienting. With some health problems, the kind of health professional you choose is quite straightforward.

What to do if your doctor doesn't recommend a specialist?

If your doctor doesn’t immediately recommend a specialist, you should ask him why. There is a chance he has a strong interest in osteoporosis and always be updated with the latest developments. If so, that’s a good thing. However, if you think a specialist is better, tell your doctor.

Who can diagnose metabolic bone disease?

Ask your doctor if he has taken such trainings. Some rheumatologists, orthopedic surgeons and endocrinologists often can diagnose and treat patients who have metabolic bone disease accurately, because their works often involves studying bone problems. For unusual or difficult cases, metabolic bone specialist is often a good choice.

Does it hurt to see a family doctor for osteoporosis?

Starting with a family doctor or any medicine specialist won’t hurt. Some family medicine doctors or internists have a special interest or experience in osteoporosis and can be perfectly capable of dealing with your care.

How to prevent osteoporosis without medication?

Answer. There are many ways to prevent and treat osteoporosis from worsening without taking medications. One way is through your diet. It is important to get adequate amounts of calcium and vitamin D because they help build and preserve your bone strength.

How often is Prolia injected?

Prolia, with the generic name Denosumab, is a type of monoclonal antibody, which stops the natural breakdown of bones. Prolia is injected two times per year. It should only be used if other treatment methods have failed or by post-menopausal women who have severe osteoporosis. The National Women’s Health Network suggests women try other ...

What is the disease that causes bones to become weak and fragile?

Osteoporosis is a disease that causes your bones to lose tissue and become weak and fragile, potentially leading to bone fractures. Prevention and treatment methods can help inhibit fractures and decrease the severity of osteoporosis. Is Prolia a Safe Treatment Option for Osteoporosis ?

What are some exercises that help with bone density?

Examples of weight-bearing exercises include hiking, jogging, and stair climbing. Examples of muscle-strengthening exercises include weight lifting and weight machines ...

Can you overdiagnose osteoporosis?

You should consult with your healthcare provider to discuss what osteoporosis treatment method is right for you, whether that includes a medication or non-drug alternative.

Prognosis

Diagnosis

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Quotes

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Results

Medical uses

Research

Diagnosis

Treatment

Clinical Trials

• Raloxifene (Evista), a selective estrogen receptor modulator (SERM), is perhaps best known for its role in breast cancer prevention and treatment, but it serves double duty in treating osteoporosis, too. It works by binding with estrogen receptors around the body to produce estrogen-like effects, one of which is to decrease bone turnover. \"For peo...

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