Alendronic acid: Been to the dentist today cos have... - PMRGCAuk

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Alendronic acid

Suet3942 profile image
33 Replies

Been to the dentist today cos have an infection under a crown.

It’s got to come out but because I have taken AA I have to go to a hospital apparently. Even though I stopped taking it 9 months ago my lovely dentist said I have to be 2 years free of it. Just to make everyone aware. 🌸

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Suet3942 profile image
Suet3942
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PMRpro profile image
PMRproAmbassador

One is left to wonder what gives him the 2 year figure - the stuff is there until the grave...

Suet3942 profile image
Suet3942 in reply to PMRpro

Really? Oh gawd!

CT-5012 profile image
CT-5012 in reply to Suet3942

You will cope I’m sure. Sympathy for the infection under a crown been there got the t-shirt, ouch.

Suet3942 profile image
Suet3942 in reply to CT-5012

Thank you CT. Touch wood it’s not hurting yet. Just slightly sore to touch the gum. I e hot antibiotics just in case. X

PMRpro profile image
PMRproAmbassador in reply to Suet3942

It is bound up in the bones - after 10 years of it being on the market they announced it was still there after 10 years.. At 15 years it will be 15 ... At least it does evetaully become inactive - but it isn't yet clear how long that really takes. (They can't predict what they dont know)

"Half of them remain attached to the bone for approximately ten years. That’s according to a study published by The International Bone and Mineral Society titled “Long-Term Bisphosphonates for Osteoporosis: An Introduction” by Gordon J. Strewler of Harvard Medical School.

This may sound like terrible news, but please don’t despair… The same study found that bisphosphonates are active only when they’re on exposed bone surfaces, so as new bone starts to form, it actually covers the bisphosphonates, and “the drug is buried in bone and becomes inactive”.

That’s a quote by Dr. Watts in the Endocrinology & Metabolism Clinics of North America, Volume 27, Issue 2, titled “Treatment of Osteoporosis with Bisphosphonates”"

The NHS says "Once you stop taking alendronic acid, the effects of the medicine will gradually wear off. Your bones may continue to benefit for up to 5 years afterwards. The longer you take the medicine, the longer the effects will last. Alendronic acid is generally prescribed for a long time."

And we know how conservative THEY are!

Suet3942 profile image
Suet3942 in reply to PMRpro

Thank you for your very informative reply. X🌸

Jayge profile image
Jayge in reply to PMRpro

If it only works on exposed bone, what will happen if I have to have a tooth pulled. I am having pain with a tooth as part of a permanent front bridge, had root canal but still hurts and gum hurts, really concerned about removing this four tooth bridge, extracting the root canal tooth. I am on Prolia and it is similar to AA pills which both can cause necrosis whereby the hole will no longer hold an implant because of necrosis. When you stop Prolia, you must start on the osteoporosis meds which can also cause necrosis.

Anyone had similar situation of needing extraction while on osteoporosis injections or meds?

PMRpro profile image
PMRproAmbassador in reply to Jayge

It doesn't only work on "exposed bone" but whether any dentist will happily extract teeth remains to be seen. Some will, some won't.

If you want an answer to this you would be better asking it in a new thread - then more people will see it because of the way the forum works.

in reply to PMRpro

My dentist 7years+ yesterday when we discussed removing a crown! 😱

PMRpro profile image
PMRproAmbassador in reply to

Because that is the first figure they have - it will rise.

Mitziecat profile image
Mitziecat

Hi. I also had an emergency dental appointment today and was found to have an infection under my crown. Was told it might eventually have to come out. The dentist didn’t seem to think that antibiotics would be very effective as the infection was localised. I insisted on having it anyway & explained that I could not afford to leave any infection untreated with my condition. In some ways I was relieved as I was stressing that the pain in my gum might have been the dreaded jaw pain I have been told to be on the look out for. I stopped AA about 3 months ago after being on it for a year.

I have found that Ibuprofen helps to relieve the pain. I gave in & took some as I am only now on a low dose of Prednisolone. Hope your infection clears and the tooth extraction is not required.

Suet3942 profile image
Suet3942 in reply to Mitziecat

Thanks Mitziecat. No he said I’ve a fracture near the root. Can’t save it. It’s already been infilled to an inch of its life. X

SheffieldJane profile image
SheffieldJane

Poor you Sue! You’ll be safe though. I hope it all goes well for you. I was fortunate in that penicillin cleared my infection up and everything settled. I guess they tried that?

I kind of knew this about AA ( part of my personal case against accepting it). However, awaiting second DEXA scan results, might not be able to dodge the bullet this time.

ClarkB profile image
ClarkB in reply to SheffieldJane

I’m still not taking it, despite my dexa scan showing some deterioration in my hip, but nowhere else. I have swallowing and obstructive airways disease (‘ok’ -report from 2013) anyway. Still the doctors want me to take it. At my last visit I was told that if I fell, broke my hip, then infection could set in and could die. Felt scared but still want to avoid it! I also have some dental problems, so don’t want my teeth and gums jeopardised either!

PMRpro profile image
PMRproAmbassador in reply to ClarkB

Who said that? What an appalling thing to threaten.

ClarkB profile image
ClarkB in reply to PMRpro

I wondered if the fact that she is a new young doctor at the practice (around 28, I thought) that all she saw was some old lady who ought to be given the facts. When I left I thought in future I would try and see someone older!

PMRpro profile image
PMRproAmbassador in reply to ClarkB

There are facts and facts. Low bone density does not automatically mean fractures and high bone density does not automatically mean no fractures. There are many other factors to consider. That is NOT the way to go about getting patients to do what you want.

ClarkB profile image
ClarkB in reply to PMRpro

Thankyou for this information. I did feel uneasy when I left the surgery, and as my ten minutes were up I couldn’t say anything else!

Suet3942 profile image
Suet3942

Yes you did the right thing Jane. Even though I decided to stop taking it, the damage is done. X

I'm sorry to hear if your problem and hope you get it sorted out.

I wonder if you had a full dental check up prior to starting the AA? The dental risks are known and my GP phoned me to advise I should have a full dental exam, including X-rays before starting AA. If any dental work required, that was to be done before taking the drug. I spoke to dentist who said many dentists refer AA patients with problems to hospital dentist. I wish you well.

Suet3942 profile image
Suet3942 in reply to

Yes I did but that was about 3 years ago.

in reply to Suet3942

That's really tough Suet3942. Good to hear it was informed risk. It's so difficult; it's only a snapshot and things change. Seems sometimes we're damned if we do and damned if we don't...so many decisions to make about things so difficult to understand! I hope you're treated soon and it gets sorted for you.xx

Suet3942 profile image
Suet3942 in reply to

Thank you. It’s a minefield. X

ClarkB profile image
ClarkB in reply to

Further dental work might be necessary in the future, despite checks. What then, if on AA?

in reply to ClarkB

Checks are just a snapshot at that point. My dentist said he'd be happy to review with X-rays etc but advised that there were no guarantees for the future. He explained the dental risk and said some dentists are unwilling to treat patients on AA. They refer for specialist treatment at hospital. He said it was up to me. If i chose the med and there were probs, he'd treat as necessary.

Suet3942 profile image
Suet3942 in reply to ClarkB

God knows! Just have to wait and see x

Jayge profile image
Jayge in reply to

I never had that advise about teeth and Prolia.

yogabonnie profile image
yogabonnie

Good luck. I am sure this precaution is just that..but always good. And here is to a quick recovery!! (from tooth and PMR woes!)

Suet3942 profile image
Suet3942

Thank you. 🌸

Mitziecat profile image
Mitziecat

Can I ask how long you took AA for? I know it is recommended no more than 5 years. I took it for a year & would think twice about restarting it. I have a Dexa scan (first one) on the 14/09/18. Will have to see what the result shows. Wishing you a quick resolution to your tooth problem. Nagging toothache is not nice.

PMRpro profile image
PMRproAmbassador in reply to Mitziecat

More recent comment suggests not more than 2-3 years.

Mitziecat profile image
Mitziecat in reply to PMRpro

Good to know. Hopefully being on it for a year would not cause much problems. I know it is prescribed in your best interest but still very worrying.

Suet3942 profile image
Suet3942 in reply to Mitziecat

I took it for 2 years mitziecat. Had second thoughts about it after hearing people’s comments. Have had a dexa scan which showed slight osteoporosis but at the time I was taking omeprazole which I discovered, stops the absorption of calcium. I do not take it now. Just have yoghurt with the pred. Good luck with your scan x

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