I have two very conflicting reports on AA. I was prescribed it whilst on 5mg pred some 4 months or so ago. I didn’t take it as dentists threw their arms up in horror! I took their advice as I was having implants and have one other bout to go through. This morning my doctor told me I must take it to protect my bones. I am awaiting dexa scan but don’t know when that will be.
Feel between the devil and the deep blue.
Any comments greatly appreciated. Thank you, I have learnt so much on this site that didn’t come from my GP.
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Marjorie237
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Well you can’t take it while you are having Dental Work done, you are advised to see your dentist before you take it & have any treatment required, your Doctor can’t go against that as it’s on the Patient Information Leaflet (PIL) & waiting until you have had a DEXA Scan is really the best course.
I’ve personally took it, following my DEXA Scan & have been on the Zolendronic Infusions since but both times l was advised to see my dentist & have treatment required.
After that, it’s another story but for now l wouldn’t worry about it because you can’t take it.
Wait for the Dexa Scan..............you might need nothing, I did and I had GCA for 5 years, high pred, and no loss of density in bones.
In the meantime, visit the National Osteoporosis website and read up on all the alternatives to AA. There are quite a few and more friendly to not running the risk of jaw necrosis, which is what your dentist is worried about...........with good cause talk to him/her about their reason.
Hi marjorie237. Why are you on pred? 5mg very low dose. I wouldn’t take AA until you have a dexa scan. I had side affects when I took it stomach pains nausea etc. Told my consultant and he said stop. I had dexa scan and have osteoporosis so now have yearly infusion but was told if bones ok on low dose pred no need for AA?
Wait until you have the dexascan result. You won't crumble in a couple of months and especially not at 5mg! The rubrics say that any major dental work must be done before starting AA - and you are in that process. If the doctor wanted to get iffy he should have done that long ago.
I was handed AA and took 4 tablets before discussing it with a different GP having done my research. He agreed with me to wait until I had figures from the dexascan. My t-scores were excellent, barely lower than the figures for 30-year olds, I was 57, and there was no need to do more than take calcium and vit D supplements which i have done the entire time I have been on pred, now nearly 10 years. After 4 years there had been no identifiable change in bone density (it was done on a different machine so not directly comparable) and after a further 3 years only a very slight change and still very much not requiring treatment.
Not everyone develops osteoporosis while on pred, some have it before starting pred and that is when the most important dexascan should be done, to get a baseline. Now you are in the process of major dental work - absolutely no AA until it is finished, if then. That will depend on the dexa results.
Hello there, I started on 60mg at 54 and refused to take AA until a DEXA. Although not happy the doc did admit that it takes months for it to develop if due to Pred. My scan some weeks in showed osteopaenia, probably due to a pre-existing severe vit D deficiency and surgical menopause at 41. It had dropped 10% in 13 years. I spoke to my dentist because I have a wonky bite and it is only a matter of time before my teeth give up and he was very unhappy about AA. I also have a cancer gene and my uncle with it died of oesophageal cancer. The assessment tool (FRAX) that can be used said I came just below the line for treatment, even with Pred factored in. So on that basis I decided to correct the vit D and use a conservative method for increasing my bone density; there are some very good books on it. I have yet to see if I took the right decision. I have had Pred for 2 years and in the last year have had a couple of very bad falls onto a hip (misadventure rather than every day trip) and no breaks. I do think the general medical world hasn’t caught up yet with the equation not being as heavily weighted in AA’s favour as previously thought, particularly in a just in case scenario. It isn’t black and white but a DEXA scan may make it more so and as has been said your bones aren’t going to crumble overnight, plus the fact you are only on 5mg.
Hi you would have to start new thread. Make sure you are keeping some pred in you. I am just recovering....not pleasant! Norovirus is popping up lots of places. Hope you feel better soon.🌻🤞
Hi...I am in same boat, and grateful for this site, as my GP very keen to put me straight on, and did't ask about my dental state (not brilliant and need a bit of work) and my dentist said I had to have work first and very against AA if works needs to be done, as it has a very long half life (6 months in body)
So I had some great advice here, have pushed for a bone scan (had yesterday) and awaiting results.
Hoping it's normal, but if not, at least I know and have a baseline to compare w down this journey.
AA is still to be found in the body up to 15 years later - and that is only because it is only about that long since it started to be used widely. As time goes on, that figure will rise.
I was prescribed AA by my gp, but didn't take it. When i saw my rheumy she said it shouldn't be started unless a DEXA scan had been done. After I had mine it was decided that as I had some osteopenia in my lower spine I should start taking it. I took it for approximately 6 weeks, following all the instructions to the book, but still ended up with a stomach ulcer the size of a 50 pence piece😱
My advice would ge to wait until a) you've had the scan and b) until your dental work is completed as AA can have devastating effects on the jaw bone
MY own dentist (currently completing two implants for me) said that AA should be avoided if dental treatment involves any work at or near the jaw bones (extractions, root canal work, implants etc.) Subsequent healing time of at least 3 months is needed before AA is taken. However, he wasn't worried about ordinary fillings, crowns or hygienist treatments. Nor was he worried at all about Pred and said it has no implications for dental work. I guess some doctors forget that their patients also need to visit dentists !
Thanks for that. What worries me is that the GP I spoke to the other day said she had never heard of osteonecrosis in the jaw as a result of AA!
Was also told by this GP that her colleague had not ordered the DEXA scan as promised. I hope it is not too long in seeing, for the first time, the rheumatologist...
Agreed, probably not! Time to look for another surgery soon! Must admit I am getting stressed with all the different GPs advising different methods and never being told much detail about PMR, have realised more in this past week or so since reading this site than any GP in the past year.
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