Alendronic Acid

[kalimche]

Good morning! I have been taking Alendronic Acid once a week for the past 8 weeks.

Last night 1 side of a tooth crown broke off (it has been cracked for the past year). In the expectation that I will get to see the dentist next week, do you think I should NOT take the AA dose due tomorrow ... I do not know whether a crown replacement would be classed as an "invasive dental procedure"?

Any advice/thoughts gratefully received!

[Hidden]

Hi, did you get your teeth checked before you started the AA as that is the recommendation?

I’m not sure stopping it tomorrow would make any difference, but as it’s a replacement Crown it’s not like tooth extraction.

Ring your Dentist anyway to check what he thinks, would be my best advice.

MrsN

[suzy1959]

I agree with Mrs Nails- Dentists are very wary of Alendronic Acid and people often have to go to hospital for any procedures.

[SnazzyD]

Typical eh? I guess your first port of call is asking the dentist. Was there a reason why it wasn’t repaired before starting A.A?

[TheMoaningViolet]

Hi kalimche, my rheumatologist told me that AA stays in your body for 6 months and up to a year after you stop taking it, so no point in interrupting your medication for an emergency dental treatment. He also told me that superficial treatments (and that includes crowns) should not be a problem only where you need to mess with the bones in your jaw. Remember that some people are on this medication for life and they still need to see a dentist from time to time, so fingers crossed all will be well.

(I am on AA and I always think that any side effect is going to affect me, so I know how you feel.)

[kalimche]

Thanks everyone for your replies. Given that I have a history of gum disease, I see both the dentist and dental hygienist regularly and I did ask them about taking AA prior to starting and they said they had no objection as no dental surgery was envisaged and my gums were currently in a good state. But I must admit I had forgotten about the cracked crown! I wanted some advice before contacting the dentist as I do not know if I will be able to talk to her before attending the appointment - but I will phone now and see what they say. Meanwhile I will probably continue with the dose in the morning.

[PMRpro Ambassador]

It would make no difference - once you start taking AA it remains in the body and that is what scares denstists. Were you not told to get any outstanding dental work done before starting it? And that you need to be scrupulous with dental hygiene while on it?

However - a crown replacement should not be an invasive procedure.

[MhairiP in reply to PMRpro]

Does AA remain in the body for ever? My dentist said it does, but I was sceptical! (Following this thread with interest because I've got a prob with a tooth - stopped taking AA 6 months ago.)

[PMRpro Ambassador in reply to MhairiP]

It is bound in the bones. AA has only been in wide use for about 20 years - the last tests done showed it persisted for 15 years - I imagine every test will show increasing times.

[MhairiP in reply to PMRpro]

Crikey! 😳 I only took it for 6 months, so although it will still be bound in my bones, it will be to a lesser extent than someone who has taken it for 2 or 3 years?

[PMRpro Ambassador in reply to MhairiP]

I assume so - but how much quantity counts I don't know.

[kalimche]

Given my gum disease, I know all about dental hygiene! And no - dental surgery just said they had no problem with my starting on AA. Because I was wary of the potential side affects, I had tried to argue against taking it. In fact I only started to take it 5 weeks after initially prescribed by my GP, since it was my Rheumatologist who said she thought it really important that I take it - despite my gum disease. My GP had armed me with the results of her fracture risk calculation (which demonstrated I was at "high risk without the need for BMD") and had left me to discuss it with the Rheumy. I also tried to request that I have a DEXA scan first - but got nowhere! In the end we reached a "compromise" - I agreed to start the AA and stopped taking the daily Lansoprazole my GP had prescribed at the start of the Prednisolone.

[MhairiP]

I'm not a pharmacist and know next to nothing about medication, but that seems a strange compromise to me! (stopping a med that helps reduce acid & replacing it with AA)

I hope your dentist's appointment goes well next week.

[kalimche in reply to MhairiP]

Put like that - maybe it wasn't such a bright idea!! I had read on these forums that PPIs like Lansoprazole are as bad as the steroids for causing osteoporis, and since I have no digestive or acid problems, I preferred not to continue to take it. Fortunately, since starting on the AA (and ceasing the PPI the following week), I still have not had any gastric problems. I take the Pred (just reduced down to 10 mg after 13 weeks) either after breakfast (porridge oats and sometimes a banana) or with a couple of spoons of yoghourt, and also take the chewable calcium and Vit D tablets, along with vitamin K capsules. So far it seems to be working for me.

[kalimche in reply to kalimche]

That should be Vit D3 and Vit K2.

[Omanain]

Hi, up to 10 years ago I suffered frequently from gum disease, but then I bought a water flosser which cleared it up and I have had no problem since. In fact my dentist now says my oral hygiene is excellent! Best of luck, Kate

[kalimche in reply to Omanain]

Thanks Kate. Ah yes - tried that too! Have found the electric crosshead brush to be best - along with various sizes of interdental brushes. Currently my teeth and gums are in good shape (bar the broken crown!) but is something I have to be constantly on top of.