Ask Dr Gary: Save your gums

I read your column and thought I would share my experience of using the drug Fosamax (for osteoporosis). I had a tooth out at the dentist, who took one look at my mouth and promptly asked me if I was on Fosamax, which I was. She said it was a mess, and recommended I go off it immediately. I was told it should have been stopped six weeks prior to the extraction, but that is not possible in emergencies. My doctor ultimately took me off Fosamax, first for six weeks, and then permanently. I am supposed to have bone density tests regularly, but it is too expensive. I would be interested in your comments.

A.S. Rotorua (edited)

Osteoporosis affects a large number of New Zealand seniors: half of all women and one-third of all men over 60 will suffer an osteoporotic fracture. One-third of those who fracture a hip will die within one year.

Bisphosphonates such as Fosamax work by making bone harder. Not necessarily healthier, just harder. The result is half as many hip fractures in the first three years for patients on Fosamax, with the benefit waning beyond that time frame. About 100 people would need to take Fosamax for three years to prevent one hip fracture. Not a stunning success, but better than any other class of medications.

However, this medicine does bring with it a very low risk of causing fractures ( about one in a thousand users) and periodontal (gum) disease.

So what else works to prevent osteoporosis? Weight training.

Weight training at high intensity and low repetitions forces the bones to lay down more calcium in a healthy way. Not many elderly women lift weights at 70 per cent of their maximum, but they should. Beyond stronger bones, weight lifting reduces the rates of falls in the elderly as well.

What else works? Vitamin D supplementation significantly improves bone density in about 3 per cent of users, but calcium supplements don't.

In fact, studies are showing taking calcium supplements increases the risk of heart attacks, kidney stones and may even increase the risk of fractures.