Tooth and jaw pain

I had an onlay (sort of midway between a filling and a crown) earlier this year, and my mouth has not felt right since. My dentist is excellent, and I have never had a problem with any of the work he has done on me over the years.

I have been on Actonel 35 mg for over 4 years and was also on Fosamax for a while before that. Can anyone on Actonel or Fosamax comment about tooth and jaw pain following dental work? Did you go off your medication, and if so, for how long, and did the pain abate?

I will be seeing my dentist and would love to have some feedback to share with him.

Thanks so much,
Uma

Edited November 15, 2008 at 6:18 pm

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Uma -- As I shared with a member yesterday, I had been on Fosamax for about 5 -6 years when I had to have extensive dental work done (caused by another drug, but not related to this story.) Yes, I suffered from pain, to the point that I thought I needed root canals at three locations. That pain, after another two years, is still there, but there is nothing wrong with those teeth. Additionally, I suffered substantial bone loss in my lower jaw, leaving the front row of eight teeth loose. My dentist is also excellent. I stopped taking the Fosamax immediately. My oral hygiene is superb, and I also rinse in the mornings with Periomed, a fluoride treatment available only through dentists' offices. Gradually, the teeth tightened again. The pain in the teeth has lessened. Then, my new internist practically insisted on my starting Fosamax again because of my osteoporosis, and stupid me, I did. My internist did not believe Fosamax could have been responsible for my jaw bone loss or tooth pain. The new round of Fosamax did not seem to affect my teeth, but after several months, I began to experience joint and muscle pain unlike any I'd ever known. Again, I stopped the Fosamax. Gradually, the pain is disappearing. Now my doc wants me to use Boniva IV quarterly injections, but after reading the warning label and the comments in Inspire, I'm persuaded that I'm one of those women who simply should not take bisphosphanates. Actonel is essentially the same stuff -- in fact, I haven't heard from anyone who has noticed a significant difference among the bisphosphanates.

The early label warnings on drugs like Fosamax had to do with esophogeal and chest pain, and swallowing difficulties -- apparently thought to be the standard, and the reason for remaining upright for 30 minutes, dosing first thing in the a.m. before food, etc. Now, all the labels bear warnings about possible "severe" pain in muscles, joints and bones. This has GOT to be significant. There must be many women who are experiencing this side effect. Perhaps they previously attributed the pain to their underlying condition, and are only now suspecting the drugs, but in any case, for some women, I think pain from bisphosphanates is a real risk. I'm one of them!

I've decided to treat my osteoporosis with a combination of bioidential estrogen and progesterone. I'll use the lowest-dose Climara patch (I've had a hysterectomy) and natural progesterone which I'm able to obtain without a prescription. We'll see how that goes. I'm naive about this, and my doctors have been cavalier about explaining what's going on. I think women definitely have to take responsibility for themselves in this area.

I doubt that your dentist will be very familiar with problems caused by bisphosphanates and your doctors would probably deny a connection, but if I were you, I would be concerned. The good news -- if you're like me, your pain will abate.

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I am new to osteoporosis, and haven't even had my first visit with the healthy bone specialist. However, I have been doing some research since last week when I was diagnosed, and have read at least 15 research articles about the connection between the biophophonates and the jaw disintegration, called osteonecrosis of the jaw. This means that the jaw bones die and can disinterate. I will not even be trying any of those types of drugs due to the warnings and research about them. Good luck with your decisions.

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Uma,
As Tallbarb34 noted, you should definitely bring this topic up with your doctors. Osteonecrosis in the Jaw is not as common as osteonecrosis in general (which I have had, and both hips replaced). But there are others who have; I know in a support group. It IS known to be a bad side effect that some can get from biphosphonates.

You may have to get a few opinions and trials for diagnosis. First time when my hips hurt badly, I saw doctors who even took x-rays and said they were fine. But then I (and esp. my family) insisted on full scan, which diagnosed in both hips. They also both collapsed right away. (However, as not jaw, this was from prednisone, not biphosophonates.)

Good Luck!

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I started Evists 1/28/07 along with Fosomax 7/24/07 and by l/08 could no longer take the pain in my upper teeth on left side. Dentist said there was nothing there thru x-rays.
Quit taking them both and pain subsided but every so often get a twinge still.

My neighbor was on Actonel, I believe, and her teeth deteriorated under her caps - paid a hefty Dentist bill to right that mess.

There is a law firm specializing in jaw deterioration - I found them on the web, but don't have the information as I type this. They were most helpful in my inquiries, not knowing if what I had was leading to something worse.

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I took Actonel 7.5 mg for about 14 months for Osteopenia, when I had a bit of throbbing in one molar and was referred for a root canal. I read some obscure minor warning about Actonel and talked to my dentists who all said it only referred to "intravenous Actonel treatment." I stopped taking it anyway during treatment.

The Endodontist told me I needed three treatments on teeth, lower right side. The first fractured and had to be pulled. I was devastated because I never lost a tooth (I was 61 at the time). The second molar also had to be pulled for reasons I can't tie to Actonel. However, when she started on the bicuspid she told me the tooth was loose! It started to throb but she did a root canal. It never stopped hurting but the Dr told me I HAD to get the crown, which I did. The tooth never settled, and after months of pain I had that one pulled. I decided to get two dental implants. After two months of smooth sailing, one started to throb. I will get the crowns placed on them in one week. I know by the way they feel that I won't be able to chew on these teeth. I just hope the implants aren't failing.

Figuring that my dental problems have been taken care of, I started taking Actonel again last month. Two weeks after, I started having severe throbbing pain in my upper front teeth! I got so depressed and scared I just seemed to lose my focus. Finally the pain was so bad I called my dentist. I have an appointment to see my dentist tomorrow.

Note: I do not have gum disease (I was checked by a Periodontist), and all five dental specialists cannot explain these multiple complications. I have always taken good care of my teeth.

This nightmare just doesn't seem to end. It's been 16 months of dental complications and pain! Since I have Osteopenia and not Osteoperosis, I decided to get a treadmill for exercise, increase my calcium intake and do whatever I can to strengthen my bones without these drugs.

People need to be warned!

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I was very sorry to read about your dental experience. I've been on Actonel since 8/01. Over the years, I have educated my dentist regarding bone loss and dental care. Several of my bottom teeth have been bonded. I recently had a crown procedure. Prior to the procedure, my dentist suggested a anti microbial, anti fungal rinse. My dentist didn't have any concerns, but said it doesn't hurt to err on the side of caution. Please educate dentists. Print out the information and highlight .... Not what may happen, but what may be done to avoid complications. Please don't rely on health professionals to stay on top of all of the information regarding osteoporosis. It's our responsibility to advocate for our own health.

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I started Actonel about 7 years ago as I had osteopenia and had a family history of osteoporosis. I have always been scrupulous about dental care and get my six months check up faithfully. I have had several root canals, all if which healed well, until this summer.

In June I started feeling a dull ache in my upper right jaw, although the aching did at times include the lower right jaw. After a few weeks of this I consulted my dentist, who found a molar on the upper right that, he said, needed a root canal. Given my good history with root canals, I agreed.

Well, this root canal, completed August 13th, did not "cure" the intermittent pain - there are days with no pain, then days of that same dull aching. Still on the right side.

I have decided to stop taking Actonel until I thoroughly discuss this with three people: my dentist, my GP and my bone specialist. I think we all have to ask the questions and demand the answers before deciding whether or not to continue with a drug.

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I have been on Actonel 35 mg for 8 years. this year i have had 2 root canals and a permanent bridge done. I have had no problems.

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