Forteo (teriparatide) is a medication prescribed to treat osteoporosis, a condition characterized by weakened bones and an increased risk of fractures. This medication functions by stimulating new bone formation, unlike other treatments that primarily slow bone loss. While Forteo offers significant benefits for improving bone density throughout the body, some individuals may have questions regarding its potential, rare, effects on oral health and the jawbone.
Forteo’s Impact on Oral Health
Forteo, a synthetic form of human parathyroid hormone (PTH 1-34), acts as an anabolic agent. It works by intermittently activating osteoblasts, which are the cells responsible for creating new bone, more than osteoclasts, the cells that break down old bone. This unique mechanism helps to increase bone mineral density and strength throughout the skeleton, including the jaw.
One specific concern sometimes associated with bone medications is osteonecrosis of the jaw (ONJ), a rare but serious condition where bone tissue in the jaw dies and becomes exposed in the mouth. While ONJ is more commonly linked to other types of bone-modifying drugs, particularly bisphosphonates and denosumab, Forteo is generally considered to have a different profile. Studies suggest that Forteo may actually promote bone healing and has been investigated as a treatment for ONJ, rather than a cause.
The incidence of ONJ in patients taking Forteo for osteoporosis appears to be extremely low. The anabolic nature of teriparatide, which stimulates new bone formation, suggests a protective effect on jawbone health and healing. Therefore, while oral health is always a consideration with any medication affecting bone metabolism, the direct link between Forteo and ONJ as a primary side effect is not established in the same way as with other antiresorptive therapies.
Identifying and Addressing Oral Concerns
Despite Forteo’s generally favorable profile regarding jawbone health, it remains important for individuals to be aware of potential oral issues. Symptoms that could indicate a problem, including ONJ, involve pain or swelling in the mouth or jaw, numbness or heaviness in the jaw, or the loosening of teeth. Exposed bone in the mouth that persists for eight weeks or longer, particularly after a dental procedure, is a defining characteristic of ONJ.
Other signs include poor healing of the gums, especially following dental work, or signs of gum infection with discharge and bad breath. If any of these symptoms arise while undergoing Forteo treatment, seek prompt medical or dental attention. Early detection and communication with healthcare providers, including both the prescribing physician and dentist, are helpful for appropriate evaluation and management.
Strategies for Oral Health While on Forteo
Maintaining excellent oral hygiene is a proactive step for anyone, and it holds particular relevance for individuals taking Forteo. Regular dental check-ups are important, allowing dental professionals to monitor oral health and address any issues promptly. Also, inform all dental professionals about Forteo use before any procedures, as this allows for coordinated care.
Good daily oral hygiene practices, such as consistent brushing and flossing, help prevent gum disease and infections, which can be risk factors for oral complications. While routine dental work like cleanings, fillings, and crowns typically do not require medication adjustments, invasive dental procedures, such as tooth extractions or implant placements, should be discussed thoroughly with both the prescribing doctor and dentist. A comprehensive dental examination before starting Forteo helps ensure any existing oral health issues are addressed beforehand.