AME: Polypharmacy, Comfort Food and Bisphosphonates

Dr. Alan Mead, a dentist with nearly three decades of practice, confronts the emotional and clinical challenges of treating an aging patient population—particularly those over 65—whose dental health is deteriorating rapidly due to polypharmacy, dry mouth, comfort food habits, and bisphosphonate use. He reveals that many of his long-term patients, once healthy and diligent, now face accelerated decay not from poor hygiene, but from a perfect storm of medications that dry the mouth, reduce saliva, and impair healing. The situation is compounded by the fact that many patients have lost dental benefits upon retirement, making restorative work financially unsustainable. What’s more, bisphosphonates—commonly prescribed for osteoporosis and cancer—create life-altering risks for dental surgery, including jaw bone necrosis, leaving dentists with few options. Mead admits he’s been unprepared for this reality, and now feels a deep professional and personal responsibility to shift his treatment planning earlier, with more aggressive monitoring and preventive care. He shares a personal reckoning: his own aging, his son’s upcoming prom, and the realization that he, too, is not immune to the same health challenges he sees in his patients. The episode ends with a raw, vulnerable plea for community input and support, as Mead seeks solutions to a crisis he sees as inevitable but deeply painful to navigate. The core insight?