What are the effects of Denosumab on teeth?

Denosumab is a medication used for the treatment of osteoporosis and the prevention of fractures caused by cancer metastasis to the bones. It is administered by injection. Generally, as an anti-bone resorption drug, denosumab may affect the teeth and oral tissues, mainly including the risk of osteonecrosis of the jaw, gum infections, tooth loosening, delayed healing after tooth extraction, and oral mucosal ulcers. The specific effects are analyzed as follows:

1. Risk of osteonecrosis of the jaw: Long-term use of denosumab may increase the likelihood of osteonecrosis of the jaw, presenting as exposed jawbone, pain, infection, and severe cases may involve bone surface necrosis and pus discharge. This is related to the drug's suppression of osteoclast activity, which affects the normal repair and regeneration of the jawbone, especially more likely to occur after tooth extraction or oral surgery.

2. Gum infection: Some users may experience symptoms of gum infection such as redness, swelling, pain, and easy bleeding. Bacteria in the mouth can easily invade the gum tissue and cause inflammation, which is associated with the drug's impact on local oral immune function and reduced tissue repair capacity. Symptoms may worsen if daily oral hygiene is inadequate.

3. Tooth loosening: The drug may affect the stability of periodontal tissues, leading to reduced tooth support, resulting in tooth loosening and weak biting force, especially noticeable when chewing hard objects. This is because the metabolism of jawbone is inhibited, weakening the periodontal ligament and alveolar bone's ability to anchor the teeth.

4. Delayed healing after tooth extraction: During the use of denosumab, tooth extraction may significantly slow the wound healing process, prolong coagulation time, and lead to persistent bleeding, swelling, pain, and even long-term non-healing of the wound. This is related to the drug's inhibition of bone resorption, which hinders the repair and regeneration of bone tissue at the extraction site.

5. Oral mucosal ulcers: A small number of users may develop oral mucosal damage or ulcers accompanied by significant pain, which can affect eating. This may be related to the drug's impact on the renewal and repair capacity of oral mucosal cells, resulting in reduced resistance of the mucosa to external stimuli.

During the use of denosumab, it is important to enhance oral care, maintain oral hygiene, undergo regular dental checkups, and avoid invasive procedures such as tooth extraction, which can help reduce adverse effects on teeth and oral tissues.