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Topic: fosamax and mandibular tooth extraction

Forum: Bone Health and Bone Loss —

Talk with others about bone density, osteopenia and osteoporosis, and ways to keep your bones strong

Posted on: Sep 19, 2015 05:15PM

Sig wrote:

HI, I took fosamax for 5 years and now i need to have a tooth molar extracted due to an abscess (root canaled did not work). I was wondering if any of you took fosamax and had a tooth extracted?? how did it go...did it heal well?? dentist and doctor said I should be fine but still remains with small risk. Dentist said the rule is to stop 3 months before and resume 3 months after, but I am about to start prolia once my dental problem is fixed. I have been off from fosamax nearly 2 years now but my bone continue to deteriorate.

sig


Dx 1/16/2007, IDC, 2cm, Stage IIB, Grade 2, 2/6 nodes, ER+/PR+, HER2+
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Sep 19, 2015 11:32PM - edited Sep 19, 2015 11:34PM by Meow13

Oh sig, my mom had to have a dental implant removed and no one wanted to do it because of the fosamax. Something about disrupting the jaw and the danger of shattering it. Found a hesitate dental surgeon and she had a successful removal. No one told her of this danger with fosamax. It healed and infection cleared up she was 78 when she had the dental implant removed. Mom doesn't have bc.

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Sep 21, 2015 03:06PM - edited Sep 21, 2015 03:10PM by peggy_j

If the infection is at the apex of the tooth, sometimes they try a procedure to remove that without extracting the tooth. (I have no idea whether this procedure has an increased risk if you've been on fosamax)

Here's some info (you may want to google around)

http://www.colgate.com/en/us/oc/oral-health/procedures/root-canals/article/apicoectomy

If you want a second opinion, dental schools often have faculty who see patients with more complicated cases. I'm assuming you're already seeing an oral surgeon (not a general dentist). Do you need to go on fosamax in the future or can you try other treatment, like SERMs?

Dx 2/2011, IDC, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Sep 21, 2015 04:22PM Sig wrote:

Meow, glad to heard that your mom healed with no problem. I just pray to go thru this with no problem, I am so scared, sometime I just feel to live with my pain, it is less intense since the root canal but I can feel that something is bothering me under the tooth and at time the pain increase, I really dont know if I should take it out or not.

Peggy, I am seeing a maxillo-facial surgeon and he is the one who recommend the extraction, never mentionned anything about the apex. I have read your link and it is involving the bone I believe. I was supposed to start prolia last June but because of my ongoing problem with tooth pain, I want to have this problem resolved prior to start prolia but now with the extraction it is going to bring me almost one year later. In the meanwhile my bone are deteriorating. I really dont know what to do.

Does osteoporosis slow down the bone healing in the jaw after extraction?

SIg

Dx 1/16/2007, IDC, 2cm, Stage IIB, Grade 2, 2/6 nodes, ER+/PR+, HER2+
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Sep 21, 2015 06:42PM Alirena wrote:

I took Fosamax for 5 years and was off it about 2 years when I had an extraction followed by an implant a few months later. No problems.

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Sep 21, 2015 08:03PM Sig wrote:

great news Alirena, this is reassuring, I am so scare, my appointment is next week. Have you started some kind of meds for your bone after your implant or your bone are stable? was it a pre-molar that was extracted?

Dx 1/16/2007, IDC, 2cm, Stage IIB, Grade 2, 2/6 nodes, ER+/PR+, HER2+
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Sep 22, 2015 08:02AM Alirena wrote:

Sig, I had tooth #30 (bottom first molar) replaced with an implant. I had a root canal first. Kept having pain and inflammation. Nothing showed up on x-rays. After the tooth developed an abscess a few years later I found out it was cracked below the gum line and could not be saved. When diagnosed with breast cancer I opted to take Tamoxifen instead of an aromatase inhibitor. Bone density has remained pretty stable for 4 years on Tamoxifen but I expect to have to take one of the bone medications in the future as I'm very close to going from osteopenia to osteoporosis. I understand your fear as I had the same concerns when faced with oral surgery.

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Sep 22, 2015 10:50AM - edited Sep 22, 2015 10:57AM by peggy_j

I think the dentists that do that apex surgery are the root canal experts, endodontists. You may want to ask your oral surgeon his opinion on whether you'd be a candidate and/or for a referral. I don't know how effective that surgery is and whether it also has the same bone risks, since it involves the jaw (though it's a smaller section of the bone). You may want to google for more info (I posted a random link), but just an FYI.

Does osteoporosis slow down the bone healing in the jaw after extraction?

That's a good question for your DDS. I asked mine and my understanding that osteoporosis doesn't impact bone healing, just bone density. She also thought that while our jaw is a big chunk of bone is doesn't necessarily become less dense when we have osteoporosis, the way that hips and spine do. (if a tooth is extracted, most patients lose a little bone at that spot after the extraction and over time. That's why many DDSs recommend a bone graft and/or an implant after an extraction. But that's different than osteoporosis). Again, I'm not a DDS so check with yours.

FWIW, I initially took tamox when I was pre-meno and had bone loss. I took a one-year break and resumed when I stopped my periods. My endocrinologist suggested that I think of tamox as reducing the rate of bone loss, but I had better results. In just one year it reversed the loss in my spine. (my hips are about the same).

Dx 2/2011, IDC, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Feb 27, 2016 08:13PM Sig wrote:

Hi ladies, i am still having dental problem and have to go through another extraction, tooth#38. Had two roots canaled, (#37,38) one extraction (#37) and still pain but if i do not touch the tooth #38 is not that bad but now the tooth is mobile, so the surgeon think it might be cracked so he recommend the extraction prior to start prolia but i am scared because of the 5 years of fosamax i had. However my first extraction healed perfectly so i hope this one will heal perfectly also. If i wouldn't have to start prolia i would wait but i have been pushing the injection since last june so i am also scare to break something also. He does not recommend that i take antibiotic prior to the extraction because i do not have an infection and it is not good for my body and as i already took (prophylactic) several times this year due to previous roots canaled and extraction. So now i really dont know what to do.

So anybody had an extraction without antibiotic?

Anybody had two extractions and had taken bone drugs?

I am so fed up of all these problems and scrary stuff.

All your inputs are very welcome

Sig

Dx 1/16/2007, IDC, 2cm, Stage IIB, Grade 2, 2/6 nodes, ER+/PR+, HER2+

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