osteoporosis and teeth problems

Hi,
I was dx with osteoporosis 11 months ago.(I am 59 years old) My dr immediately put me on fosomax. I am ususally diligant about researching meds...but, for some reason, I just took her word for it! Well, the other day, I needed a tooth extraction with the possibility of an implant. I started to do some research and was appalled at what I found. The oral surgeon assured me that since I have been on the meds less than 3 years I would be fine.(not to worry about the necrosis of the jaw,etc) needless to say, I have stopped the fosomax and am awaiting an appt with an endocrinologist to find out why my bone density is so low.
I would love to hear if anyone else has had any experience with dental work while on fosomax.

Edited October 1, 2009 at 2:01 pm

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13 replies. Join the discussion

My mother is 95 years old. She has been on Fosomax for 5 years. She had a tooth extraction last year. She had no problems.

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Thanks for that info!

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trb, you may want to suggest to your dentist that an antibacterial rinse prior and after the procedure may be helpful. It's the bacteria that becomes impacted that may cause problems, but if the dentist is aware of bone loss and takes some simple caution with the procedure, most problems can be avoided. Sandi

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trb,
I took Fosamax for 13 years. I had an impacted wisdom tooth extracted earlier this year. The oral surgeon wanted me to be off Fosamax for 2 months before he pulled the tooth. Fortunately I had been off of it for 6 months because I was on a "Fosamax holiday" for a year. I had no problems with my jaw though I did suffer from dry socket for a few weeks and my gum was slow to heal. Otherwise I didn't have any problems.

Peggy

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I lost perfect molars in my early 40's, due to jawbone loss, which should have been the first sign of the possibility of osteo. I had my first bone density test when i was 54, diagnosed with osteo, & was imediately recomended by my endrocronologist to go on Forteo, my miracle treatment.( explaining to me about the risk of biofosphates & jaw bone loss) It was also pointed out that I had scoliosis, but I do not know if it is due to the osteo, or if I had it dating further back in my life. I have written before & talked about having my thyroid out when I was younger, & I still have very strong beliefs that this is the main cause of my osteo. Forteo has been great for me, gradually eliminating debilitating pain throughout my body, feet especialy in my back, it sometimes feels so weak as if is about to break. I will have my next bone density in Nov. & I am hoping for some great improvement. Thank u for this website!!! I will post my results!!

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Trb,
I have a good friend that took Fosamax for over a year.
She had two teeth extracted, at two different times, since taking Fosamax.
Her Dentist just ask her, if she was taking Fosamax?
She said yes, he told her the side effects, which her Dr. never did!!
He advised her to stop taking it.
She has stopped.

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I was interested in reading everyones replys as I have been on Actonel (fosomax didn't agree with me) for about 4 years and I need a tooth pulled and an implant and have been putting the proceedure off for fear of jaw problems...I am 68 and was diagnosed with Osteo at age 50 so I have been on and off various meds since then...I stopped taking my Actonel about 5 months ago...haven't told my Doc yet but will see her in a few months...I just didn't want to take a chance and figured I would just put myself on the med holiday...I have yet to have the proceedure as I usually don't heal fast so am a bit nervous anyway...I guess everyone reacts differently to the meds...I just wish they knew more about the long term effects on us...this is a very helpful website! thanks susie

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Thanks everyone for responding! I can't believe how helpful this site has been(and will continue to be) I did have the tooth pulled and was told that I could not have an implant unless I have a bone graft from my jaw-because of bone loss. NOT GOING TO HAPPEN as far as i am concerned...how can he take bone from my jaw and expect it to 'take'-when i have so much bone loss????? + after the tooth extraction, which has been over a week ago-I have been experiencing pain (and redness) near the gum line.-after reading pgreene's response-I decided to look into dry socket-which is probably what i am experiencing. I immediately did research on this and am self treating since my dentist did not seem real interested in my one call to ask if I should still be in pain. hmmmmm

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Facing this delimma myself as I shall need gum grafting for periodontitis. I reviewed the literature (an excellent literature review is by the way posted at another site here ) and to sum:

Dental hygiene and care must be optimal before you begin on Bisphosphonates (the medications used to reverse osteoporosis). And continued . However if you have been on the medications and need dental/ oral surgery ----the consensus is 1) that oral medication (Actonel, Fosamax) is much more benign than is IV administration (ReClast, Boniva IV) and 2) the time of exposure is critical with the cut off line at three years. That is you are at a much higher risk if you have been on the medications for over three years.

If dental surgery is needed ---- and less invasive procedures like "Root Canals" ruled out then 3) a Drug holiday should be considered and this is set at three months. That is you should be off either the Oral or the IV Bisphosphonates for at least three months before dental surgery is undertaken .

I am now on a drug holiday from Boniva IV until the periodontitis is resolved. But again the risks unlike that of the Cancer patient- here are very low for the severe destruction of the jawbones called osteonecrosis. In the osteoporosis patient - still this is something that both patient and medical professional should be aware of at this time !

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thanks for sharing that info.
I have always had teeth issues (not because of poor dental hygiene) but, they seem to have gotten worse as I have gotten older. so, who knows if the problem is due to osteoporosis or ????
I have definitely discontinued the fosamax and will await my appt. with the endocrinologist!

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trb, my dentist is very pro-active with care and caution for people with bone loss. My dentist would not suggest dental implants.

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vflorence, I've had gum grafting twice while taking Actonel without a drug holiday. I've never had any problems. My dentist takes precautions prior, during and after dental procedures with antibacterial rinses. I feel it is important to have a good discussion with the dentist prior to any procedures and share printed information on osteoporosis with the dentist. Many dentists are not educated on bone loss, so it is our responsibility for our dental health to educate our dentists in the care and safety of our bones.

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i am seeing an oral surgeon.He did not seem the least bit concerned about me being on the meds. He even presented a lecture for other dental professionals re: the use bisphosphonates and oral surgery. the conclusion was that if you are on them for less than 3 years-you are a good candidate for extraction and implants...This is scary!!!

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