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bisphosphonates and tooth extraction - any experience?

(9 Posts)
humptydumpty Sun 10-Jan-21 18:48:15

Hi, I wonder if any GNers have any experience of this. I'm taking bisphosphonates for osteoporosis but now my dentist wants to extract a tooth, which can lead to osteonecrosis of the jaw.

He asked me to check with my GP but she has lobbed the ball back to his court.

The chances are low but there's no treatment and it sounds horrible.

Sparklefizz Sun 10-Jan-21 19:00:01

My dentist advised me not to take bisphosphonates because of osteonecrosis of the jaw. He has several patients who have this.

humpty your post seems to indicate that the extraction can lead to osteonecrosis of the jaw, but it's the drugs.

geekesse Sun 10-Jan-21 19:51:39

Sparklefizz, although biophosphonates may be the initial cause of osteonecrosis of the jaw (ONJ), dental work can make it worse. And in some cases, ONJ can be caused by a dental extraction without any drug involvement.

Farmor15 Sun 10-Jan-21 19:54:28

I had been on bisphophonates for a few years - stopped as Dexa scan showed improvement and knew that long term use wasn’t advised. I subsequently developed abscess on wisdom tooth and ended up having it out. I spoke to the dentist about the bisphosphonate osteonecrosis risk and he said it was very low and usually associated with people with cancer.
Didn’t have any problem after extraction or since.

lemsip Sun 10-Jan-21 19:56:18

well, first, do you have toothache? why does dentist want to extract the tooth otherwise!

SueDonim Sun 10-Jan-21 20:00:31

I had a tooth removed and an implant put in about a year ago. The specialist dentist, my own dentist and my GP all looked into the situation with osteonecrosis and biphosphonates and helped me weigh up the risks. The fact not one of these three experienced experts had ever come across an actual case of osteonecrosis associated with the drugs made me decide to go ahead.

The concern that my tooth condition could suddenly deteriorate and require an emergency dental extraction was also part of my thinking. I felt it was better to be in a controlled situation.

I won’t say I wasn’t a little worried at the time but all went to plan. I should say I no longer take biphosphantes now, as I don’t need them any more.

Marydoll Sun 10-Jan-21 20:35:30

I too had a similar problem last year, when I started developing mouth problems, after changing heart pills. My GP was worried about osteonecrosis, especially as I had severe osteoporosis and my RA was already affecting my jaw.

My dentist said that the condition was rare and he had never come across it.

Sparklefizz Sun 10-Jan-21 20:44:38

Thanks geekesse - I have learnt something.

My dentist has 3 patients with the condition (or had 10 years ago when he told me this)

humptydumpty Mon 11-Jan-21 10:00:39

Thanks so much, everyone. I've looked at the literature and I think as I've only been on BP for 2 years, and not for cancer, hopefully it will be OK. I've had an infection at the base of the tooth and am on antibiotics; I coud have a root canal filling but the tooth's in pretty poor shape so an extraction looks likely to be necessary only, and I prefer the idea of getting it done sooner rather than later.