hybridlife
12-06-2008, 10:20 PM
I have teeth that need to be pulled and am on fosomax and am worried about having the work done. I have read on the web many times where the patient should go off of the meds but other sites state that the drug stays within the system for months. There is no other option on one of the teeth. It is cracked down to the root - since I have been on the meds for about 7 months now, anyone know the risks?:confused:
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taape
12-07-2008, 03:06 PM
I"m sorry to hear that you are in this situation. This is the reason that I keep refusing to take bisphosphonates. I don't have great teeth and when I need major dental work it's usually an emergency and I can't wait. I would definitely ask to take antibiotics to lessen the chances of an infection.
omzenska
12-07-2008, 04:41 PM
I'm sorry to hear that, and this is also the reason why I've refused to take Fosamax. I agree with taape that taking antibiotics should decrease your chances of infection. Also, if possible, I'd have an oral surgeon do the extraction rather than a regular dentist, and make sure that they know you're taking Fosamax and how long you've been taking it. From what I've read, most oral surgeons will ask people to stop taking Fosamax for a few months before the extraction. Good luck!
cardjem
12-07-2008, 09:59 PM
Hi,
I am 45 years old and I was diagnosed with osteoporosis at 43 (had an unexplained rib fracture). I have been on Actonel for 2 years. I had 9 tooth extractions done in October. I told my dentist that I had been taking Actonel for 2 years.
I experienced NO ill effects from the extractions due to the Actonel, but this is just me.
Best Wishes,
Jem
I am 45 years old and I was diagnosed with osteoporosis at 43 (had an unexplained rib fracture). I have been on Actonel for 2 years. I had 9 tooth extractions done in October. I told my dentist that I had been taking Actonel for 2 years.
I experienced NO ill effects from the extractions due to the Actonel, but this is just me.
Best Wishes,
Jem
legallyblondied
12-08-2008, 03:25 AM
Hi.....as far as oral bisphosphonates and dental work go, to be on the safe side you need to have any extraction done by an
oral surgeon and let him consult with the doc who prescribed
your meds before he does the surgery. A regular dentist who
knows that you are on oral meds, would noramlly refer out
because of the potential problems that can occur. It is also
dependent on the cleaniness of your mouth and good oral
hygiene. Usually this all plays a factor and the drug that seems to have the biggest problem is fosamax. I would be
very careful and not have a general dentist do this but an oral surgeon, just to be on the safe side. It is not worth looking at osteonecrosis of the jaw later on. Karen
oral surgeon and let him consult with the doc who prescribed
your meds before he does the surgery. A regular dentist who
knows that you are on oral meds, would noramlly refer out
because of the potential problems that can occur. It is also
dependent on the cleaniness of your mouth and good oral
hygiene. Usually this all plays a factor and the drug that seems to have the biggest problem is fosamax. I would be
very careful and not have a general dentist do this but an oral surgeon, just to be on the safe side. It is not worth looking at osteonecrosis of the jaw later on. Karen
DesertBloom
12-08-2008, 08:15 PM
Hi: I agree with all the advice given by the OP's. I had 2 extractions after taking Actonel for 17 months, and didn't have any problem. I did have to have an oral surgeon do the extraction since my dentist didn't want to do it. That was fine with me, and my PCP had to give prior authorization on the extraction even though I had stopped taking Actonel apprx 1 year prior to the extractions, plus I didn't ever take Actonel again because I went on Forteo. My stopping Actonel had nothing to do with the extractions; I did so because I went on Forteo instead.
This problem is mainly seen in patients who took iv bisphosphonates for cancer, which is a much stronger dose than what's given for osteo, plus it's administered more often as well. That doesn't mean this is a non-issue; according to Merck there are some oral BP users who claim they contracted BON (bisphosphonate associated oral osteonecrosis) though it's a low number of people if you look at the total of people who've taken this over 15 or so years. I would take whatever precautions you can to prevent infection. Ask your surgeon what that might be. In my case it was antibiotics, diligent oral cleaning care and chlorhexidine mouth wash for a limited amount of time. Those with periodontitis or other gum diseases are more prone to infection and therefore at greater risk.
Below is a link from the American Dental Assoc (ADA) with recommendations on this topic that might help. I don't believe it says how long to discontinue the med, but it gives other recommendations. Also this link was just updated several days ago, but to access it you have to pay for the article and it's pretty expensive. I don't know what it says since I didn't pay for it, but if you want to read/pay for it, you can find it pretty easily by going to the ADA. The abstract is available free, but it doesn't say much more than what the link does below.
http://www.ada.org/prof/resources/pubs/jada/reports/report_bisphosphonate.pdf
Good luck with your surgery...:angel:
This problem is mainly seen in patients who took iv bisphosphonates for cancer, which is a much stronger dose than what's given for osteo, plus it's administered more often as well. That doesn't mean this is a non-issue; according to Merck there are some oral BP users who claim they contracted BON (bisphosphonate associated oral osteonecrosis) though it's a low number of people if you look at the total of people who've taken this over 15 or so years. I would take whatever precautions you can to prevent infection. Ask your surgeon what that might be. In my case it was antibiotics, diligent oral cleaning care and chlorhexidine mouth wash for a limited amount of time. Those with periodontitis or other gum diseases are more prone to infection and therefore at greater risk.
Below is a link from the American Dental Assoc (ADA) with recommendations on this topic that might help. I don't believe it says how long to discontinue the med, but it gives other recommendations. Also this link was just updated several days ago, but to access it you have to pay for the article and it's pretty expensive. I don't know what it says since I didn't pay for it, but if you want to read/pay for it, you can find it pretty easily by going to the ADA. The abstract is available free, but it doesn't say much more than what the link does below.
http://www.ada.org/prof/resources/pubs/jada/reports/report_bisphosphonate.pdf
Good luck with your surgery...:angel:
hybridlife
12-09-2008, 01:26 PM
Well it is done - was referred out to an oral surgeon. We discussed the fosamax and went ahead with the oral surgery. I hope all will be well (he thinks so too - has had many patients with the same thing and all ok). Back to drooling in my dixie cup! :D