Online Dental Education Library

Dr. Goldman and his staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions, please contact us.

Oral and maxillofacial surgeons are unique among dentists in that they all have completed an additional four years of hospital-based training alongside medical residents, and can administer all types of anesthesia. If you have a diseased or impacted tooth that needs to come out, implants to be placed, a suspicious lesion that needs a biopsy, or any other oral health condition requiring surgical diagnosis or treatment, we can help. Learn more about Oral Surgery.

Snoring & Sleep Apnea

Chronic loud snoring is a common symptom of Obstructive Sleep Apnea (OSA), which occurs when the upper airway is blocked to the point of causing significant airflow disruption, or even no airflow whatsoever for 10 seconds or more. This can be a dangerous situation. Learn more about Snoring & Sleep Apnea.

Tooth Extractions

There are times when it is in your best interest to have a tooth extracted (removed). This could be the case for a variety of reasons, including: damage or trauma to the tooth; an impacted wisdom tooth that may cause trouble for you later on; or overcrowding. Learn more about Tooth Extractions.

Implant Dentistry

Dental Implant Video

If you are missing one or more teeth, dental implants offer the comfort and security of a permanent replacement that looks and functions just like your natural teeth. Dental implants also help preserve the tooth-supporting bone in your jaw that deteriorates when even one tooth is lost.

Oral Diagnosis & Biopsies

When it comes to detecting certain oral or systemic (whole-body) diseases, a thorough dental exam may be your first line of defense. Learn more about Oral Diagnosis & Biopsies.

Bone Grafting

Bone grafting, a minor in-office surgical procedure, is commonly used in dentistry to correct deficiencies in bone quality and to build support for teeth or dental implants. Learn more about Bone Grafting.

Sedation Dentistry & Anesthesia

We want you to have the most comfortable dental treatment experience possible. That's why we offer sedation, to help you relax, and/or anesthesia, to block your sensations of pain. Learn more about Sedation Dentistry.

Facial Trauma & Reconstructive Surgery

Oral and maxillofacial surgeons are capable of treating the full scope of injuries to the structures of the face, mouth or jaws — including the teeth, the bones of the jaws and face, and the tissue of the skin and gums. We can also treat congenital defects such as cleft palate.

TMJ Disorders

If you have chronic pain in or around your jaw, or find the movement of your jaw is restricted, you may be suffering from a temporomandibular joint (TMJ) disorder. Learn more about TMJ Disorders.

Treating Dental Emergencies

We can treat a variety of traumatic dental injuries, including teeth that have been moved or knocked out entirely. Please call our office for assistance, or click here to learn more about what to do in a dental emergency.

Normal bone vs osteoporosis.Osteoporosis is a condition that weakens bones and makes them more prone to fracture. Estimated to affect about 10 million Americans at present, it causes some 2 million fractures each year — and as our population ages, these numbers are expected to increase. Osteoporosis can affect any part of the body — including the jawbone that supports the teeth.

This may be of particular concern if you are considering certain dental procedures — for example, getting dental implants to replace missing teeth. Implants are today's gold standard for tooth replacement, because they look and function so much like real teeth. But their success depends on a process known as osseointegration, by which they fuse to living bone in the jaw. For this to occur, that bone must be relatively healthy; yet osteoporosis — and certain medications used to treat it — may affect your oral health.

Bone: An Ever-Changing Tissue

The living bone tissue in the body isn't like the dry, white skeleton you may have seen in a doctor's office or on TV. It is constantly being remodeled by two natural processes: resorption, in which the body removes and breaks down old, damaged bone; and bone formation, where the removed material is replaced by new, healthy bone. In an ideal situation, both processes happen at an equal rate; osteoporosis, however, tips the balance toward resorption, weakening the bone structure.

A class of drugs called bisphosphonates (whose brand names include Fosamax, Boniva, Reclast and Prolia) can inhibit resorption and help bring the two processes back into balance. But for reasons that aren't fully understood, these medications sometimes have a different effect on the bones of the jaw. In rare cases, long-term bisphosphonate users experience osteonecrosis of the jaw (ONJ), a condition in which isolated areas of jawbone lose their vitality and die. If you are a candidate for oral surgery, tooth extraction or implant placement, it's important to consider the possible effect of bisphosphonate use before you have this type of procedure.

Taking Medication

Over 90 percent of the people who suffer from bisphosphonate-associated ONJ received high doses of the medication intravenously — often for cancer treatment. Only a small percentage of those who take the drug orally are likely to develop this condition. So generally speaking, if you have osteoporosis or are at high risk of bone fractures, the benefit of taking these medications far outweighs the risk.

But if you are about to begin therapy with high doses of bisphosphonates, it's ideal to have a dental exam and resolve any oral disease before beginning the medication. Likewise, while you're receiving the medication, it's best to avoid invasive dental treatments if possible. However, since untreated oral disease may cause serious health problems, be sure to discuss the situation with all members of your medical team before making treatment decisions.

Most people who take oral bisphosphonates for osteoporosis won't have to postpone or avoid dental procedures, because they have little risk of developing ONJ. In the case of dental implant placement, the decision to proceed is made on an individual basis, after a thorough examination of the quality and quantity of tooth-supporting bone in the jaw. The presence of osteoporosis may influence the type of implants used, and the amount of healing time needed to complete the osseointegration process.

No matter what dental procedures you are considering, it is vital to keep us informed about any medical conditions you have, and any drugs you may be taking — both prescription and non-prescription.

Preventing Osteoporosis

There are several ways you can help prevent osteoporosis. For a start, make sure you're getting enough calcium and vitamin D. It also helps to decrease your caffeine and alcohol intake, and quit smoking. Weight-bearing exercise — physical activities that force you to work against gravity, like walking, jogging or weight training — can bring a host of benefits. And don't forget your regular visits to the dental office. Your dental professionals don't just help you to maintain good oral health — we encourage you to keep up your overall health as well.

Related Articles

Osteoporosis - Dear Doctor Magazine

Osteoporosis & Dental Implants If you are taking a bisphosphonate drug for treatment of osteoporosis, any kind of surgery involving the jawbone has a small risk that bone healing may be compromised. This includes tooth removal and the placement of dental implants. It's an important subject that requires a better understanding... Read Article


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