Teeth, Bones and Summer Tones

Those who have seen me in person lately may have noticed a different smile. In early June, I underwent major dental surgery involving a number of dental extractions and the placement of five dental implants. This was a first step to rebuilding a more permanent bridge.

How did I come to this decision and this timing? 

I was born with a cleft lip and palate among other birth anomalies and underwent repair for this early in life. Then came braces. Twice! After that, I had a pretty major surgery to bring my upper jaw forward in order to correct an underbite. That took place the summer before my senior year of high school. After that, my jaws were wired shut for 6 very long, hungry weeks. After that, I underwent $10,000 worth of bridgework during my materially impoverished medical school yesrs.  I am grateful to Boogie Weinglass who had a foundation to support my medical expenses during my teen and young adult years. That original bridge lasted all these years. 

Several years ago, I was found to have significant osteoporosis.  This is most likely related to treatment of stage 1 breast cancer in 2009, early surgical menopause, and probably too much coffee consumed daily over many years. I have cut back to 1/2 caff the past few years. I have also been taking brisk walks with my dog, Zeke, for at least an hour every day. I should be lifting weights more often in order to improve my bone health; though I find this form of exercise to be boring. I also take vitamin D3 2000 IU a day and try to incorporate calcium-rich foods like cheese and yogurt into my diet. 

The best first-line treatments for osteoporosis are called bisphosphonates.  Alendronate, or fosamax, is one of the most commonly prescribed bisphosphonates. These medications carry a small risk of causing an irreversible and terrible jaw problem called osteonecrosis of the jaw, or ONJ. While this complication is much more rare than the fractures caused by osteoporosis, the risk of ONJ is increased with major dental work or dental inflammation. My dentist informed me that he would not want to ever do dental implants if I had taken even a single dose of a bisphosphonate. For this reason, I made a careful decision to delay taking medication for osteoporosis and move forward with a more permanent solution to my dental health. After all the work is completed (including dental visits every other week for most of the fall), I will let my mouth heal for two years before starting on alendronate. 

I am on a soft diet for about 5 months. Yes, hungry at times but figuring it out. The diet is almost opposite my usual program; though I have been able to enjoy foods not on my usual list. My next post will be all about the foods that I have found have worked from me while recovering from dental surgery. I now have so much more compassion for people without teeth or who have missing teeth or sore teeth! Teeth are so important for our health. My smile will be different for awhile, but I am on the way to something even better than before.