Alendronic acid and dentists.: Hello I'm new... - Bone Health

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Alendronic acid and dentists.

technology profile image
21 Replies

Hello I'm new here.

I have been taking Alendronic acid for nine months after breaking my arm in an accident. Now that we are all in 'lock down' in this country because of COVID-19 (no I haven't got it or any symptoms), as bad luck would have it, I have the most painful toothache and my dentist has refused to treat me. My last inspection was in January and he told me my teeth were in good condition as well as telling me that I needed to attend every six months onward. In desperation I had to go to a dental practice 20 miles away to get an emergency prescription for antibiotics which my own dentist would not do. I was also told by my own dentist not to take ibuprofen too! So on my own admission I have decided that I do not want to take Alendronic any longer especially after being told by my dentist that it would cause a fracture of my jaw and that the cavity would not heal if I have any teeth extracted. He was very disparaging about it. Is Alendronic acid generally not a dentists 'friend'? I hope I'm making some sense! Any thoughts please.

21 Replies
CDPO16 profile image
CDPO16

I took Alendronic Acid for 2 years them stopped due to gastric side effects. During that time my dentist continued to treat me without any problem although he was concerned and was wary of potential problems because of the medication. My GP later said that doctors are fine with A A but most dentists aren't.

It does seem that your dentist was rather over the top in saying that it would cause a fracture of the jaw if you didn't need invasive treatment. I have no explanation as to why he wouldn't prescribe antibiotics.

I am sure that someone with far more knowledge than me will be along with more informative information and advice. In the meantime I'm sorry that you had to go elsewhere to get help with your problem and, if it was me, I'd be looking to change my dentist to one more user friendly.

jimister profile image
jimister in reply to CDPO16

Hi I'm on Prolia am waiting for Dental surgery. I am having mine done by an oral surgeon at the hospital not by a dentist. I have no choice as I am in pain. Sometimes these things need to be done it doesn't mean you will have jaw problems afterwards. As you get older problems with teeth seem to occur what are you meant to do? My dentist referred me to the hospital for my surgery. Although at the moment it's all been cancelled.

Blueskys111 profile image
Blueskys111 in reply to jimister

About 3 years ago I completed a year of zumeta and Xgeva to protect my bones. Was not told of side effects. Now I’m suffering from side effects. Teeth and jaw. Any trama to teeth bone will be devastating. I need to use oral antibiotics mouthwash forever. Please don’t let them give you this bone strengthening medication. It changes your bones forever and not for the better.

Blueskys111 profile image
Blueskys111 in reply to Blueskys111

Just adding to my 11 month old reply. I got very bad abscess in a tooth I was doctoring for a long time. The abscess went all the way up to my eye. I had no choice but have the tooth extracted. I consider myself very lucky. There is a new procedure when extracting a tooth under these extreme situations. Oral surgeon took blood from my arm. After extracting the tooth he injected the my blood into the socket where he extracted the tooth. I had one very bad day but the bone healed beautifully. This new procedure doesn’t always work but surgeons have had a lot of success with it. Feeling blessed. Good luck everyone. I’ll never do xgeva or it’s cousins again. Same as prolia.

HeronNS profile image
HeronNS

Denying you antibiotics is strange. I do understand the reluctance to do anything involving your jawbone, as in an extraction, but allowing an infection to remain untreated doesn't help that situation at all.

You could safely discontinue the AA for the time being. You don't have to taper off or anything like that. And what you have already taken will be staying in your bones indefinitely so it's not like stopping some of the other drugs which cause a rebound effect. When things return to something more resembling normal you can have a discussion with your dentist and your doctor about how to proceed.

And as CDPO16 said, a more sensible dentist would be a good idea.

technology profile image
technology in reply to HeronNS

Thank for your replies. I think, too, that I need a new dentist. I also think that my doctor should have been more informative about the side effects of the drug, not that I have had any apart from my dentist views.

AnnieW55 profile image
AnnieW55 in reply to technology

Have you read the AA accompanying information sheet? It’s sad to say but we can’t rely on our doctors only for information, we have to research for ourselves.

technology profile image
technology in reply to AnnieW55

Hi and thank you for your reply. Yes I have read the info sheet but did not expect to be viewed as ‘rare - more than one in ten thousand people but less than one in a thousand’ in the contra indications as the dentist appears to have categorised me. I have regular checkups, good dental hygiene and no problems until now. If I had known that this drug was derived from bisphosphonate chemicals used for water softening then I would seriously have declined to take it. However that is not really the issue. A dental practice that cannot take care of a patient in pain is. So if and when we emerge from this virus situation I shall be looking for a new dentist and take the consequences of the bone density loss of not taking ‘AA’.

Arcadia10 profile image
Arcadia10 in reply to technology

My dentist, who is very knowledgeable and whom I trust implicitly, was dismayed when I told him that I had to take a bisphosphonate as a relay drug to get off Prolia safely. He told me that the incidence of ONJ is actually around 1 in 1000. I think the drug companies downplay the real incidence as it isn't in their interests to be upfront and honest about the rate of damage their products can do. As a bisphosphonate stays in one's system for around 10 years, I will have to be referred to an oral surgeon for any invasive treatment.

vick1 profile image
vick1

I was taking AA for 10 years with no trouble at all. I then stopped for 5 years and as my bone density had gone down again I had to start taking it again, that was about 6 months ago. My dentist, and the consultant at the hospital, told me that it was very rare to get a fracture of the jaw due to AA and mostly it involved the bottom jaw - so bottom teeth. I had to weigh up the odds against getting a jaw fracture, against breaking my spine, for me taking AA came out on top. I would defiantly change your dentist whatever you decide to do.

technology profile image
technology in reply to vick1

I can understand especially when the odds are in favour of taking AA. One of my neighbours is almost twenty years older than me and broke her femur when she was knocked over in a store at Christmas. She has been put on the drug but her doctor who told her to discuss it with her dentist first which she did and was told that they didn’t have a problem with it. She is self isolating at the moment but I have made a mental note to ask for the name and address of her dentist next time I see her out.

I have experienced Jaw bone problems from Prolia and now fear all future dental issues. A few months ago (just before the world turned upside down). I had what I thought was a toothache on an upper back tooth. My dentist said it was probably from my sinuses, not my teeth. He recommended Simple Saline and by golly the problem went away with in a week.

Don't be in any rush to get dental work before trying other things. Also, stress could be a factor. (Lord knows we we all have reasons to feel stress right now).

Good luck

technology profile image
technology in reply to angryandfrustrated

Thank you for your reply.

Yes, I agree that stress can be a big factor and that there is an awful lot of stress for us all at present.

My possible cause is that I also had problems starting a petrol lawn mower when pulling the start cord that jammed which seemed to set off the damned tooth. You know the 'clenching the teeth' thing, plus shoulder and arm pain on the same side after the event. Possibly the jarring of this set it off. I'm being hopeful here. But it still does not exonerate my dentists response.

When I have had teeth extracted, in the past, and before taking AA, I had gum healing problems and quite severe infections after the event. So my preference would not be tooth extraction.

Let us all hope that there is some light at the end of the tunnel sometime soon. In the meantime take care and keep well.

Thank you all.

Walkingdogs profile image
Walkingdogs

My dentist seemed to be ok with it. She said fracture of the jaw was a very rare thing. As for ibuprofen, I was told it wasn’t good for bones especially when healing after a fracture. Hope you get rid of your toothache, there’s nothing worse. 🙂

A dentist I know takes AA.

Ab14e profile image
Ab14e

Hi technology I have been taking Aa for 3 years and have recently had a loose tooth out my dentist had put of the extraction for several years as I also take an anticoagulant double trouble but he gave me plenty of local anaesthetic the outcome was fine did not bleed to much and no broken jaw its three weeks now and gum is healing well you just need the right dentist

technology profile image
technology

Thanks for the reply. My dentist cancelled my appointments so I have not got any further with treatment due to Covid-19 pandemic. No luck with other dentists either. It's all extreme treatment or nothing.

Hopeville profile image
Hopeville

I’m just arriving at your position now ! How did you get along ? My dentist had to screen me ( orders of oncologist ) to check if I needed any major extractions in the next three years. If you to this acid apparently you can’t have any dental work done for quite some time , so this is why they send you to the dentist. Like you I’m now in the second big lockdown and trapped for options. I’m worried that the acid is a) not really necessary or proven and b) has potential hideous long term effects ( in my particular case ). I really got the feeling that the dentist was a) not all that familiar with the treatment and b) had to study my accompanying letter quite a while before advising me. Speaking to someone who’s first language is not English and from behind a mask was very difficult. I had to rely on her ‘ eye expressions ‘ and get her to repeat stuff until I got the feeling that she looked uncomfortable with the whole treatment and possible side effects . How did you get along ?

technology profile image
technology in reply to Hopeville

Hi. Really I am not much further than my last post here. But I have seen a dentist recently who says he will treat me. Hurrah - I think! I tried to get antibiotics for the tooth since it flared up again. So phoned the doctors who in turn phoned the dentist who phoned me to make an emergency appointment. Then the duty Dr phoned me back and said that my DEXA scan results didn’t fit the criteria for medication (result wasn’t bad!) so he had taken me off AA. I had stopped taking it 10 months ago anyway. Our ‘lives’ are in their hands. The dentist told me once you’ve taken AA it’s in your bones forever so there is always some risk involved. Pity that the medical profession can’t be more honest and informed about what they are prescribing. In my case the prescribing of AA was totally unnecessary. If I were you I would ask for an alternative treatment.

Update.

My follow up dental appointment was for root canal treatment which seems to have worked. I have had RCT before and find it preferable to having the tooth extracted. I was supposed to have a follow up appointment to discuss having the tooth capped but the practice phoned me to say they were only taking emergencies and that they would contact me when they had an available appointment for me. I am so glad that I don't take AA anymore. I had not realised how ill it had made me feel not to mention the attitude of the dental profession. Good luck to everyone else with either/and AA and dentists.

Maisiek profile image
Maisiek in reply to technology

Hi, I was on AA for a year last year so my dentist was very cautious about an extraction, but he took advice from a hospital consultant , put me on antibiotics the day before , stitched the cavity and all went well. You hear a lot about trouble getting a doctor’s appt but that’s nothing compared with dentists- running two simultaneously at the moment 😢 I now have a swelling inside my jaw which is being investigated ( other side) following treatment. Praying it’s nothing worrying .

notanotter profile image
notanotter in reply to technology

My specialist doctor told me, "dentists don't understand osteoporosis." He is old school and very direct. In my experience, he's right. All I've heard from my dentist is anecdotes about one patient or another, which is not reliable information when they might not even know their patient's complete medical profile.

I'm glad you found a sensible person to help you!

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