Another dental problem, Alendronic ac and implants

[HamishPMR]

I thought that I had read up well on alendronic ac and came to the conclusion that much of it's bad press was due to the unusual instructions for taking the tablet, i.e."remain upright for 30 minutes etc". So I started taking it, and did so for two years until my pred was down to 4mg daily. Yesterday I visited my dentist to discuss having another implant. He took an x-ray and commented that I had been lucky that the alendronic had not affected my other implant. Apparently the treatment can loosen implants! So, be AA and implant beware. Hamish,Edinburgh.

[MrsNails]

Hi Hamish

Whoever prescribed it to you in the first instance should have advised you about the risk of necrosis & all dental work should be completed before you start taking it.

I’m so glad it has t effected your other implant!

Best Wishes

MrsN

[PMRpro Ambassador]

One of the primary warnings with AA is that any foreseen invasive dental work be completed before starting to take it as healing of the bone may be affected afterwards. Many dentists refuse to do anything on patients on bisphosphonates and refer them to hospital specialists. And once it is in the bone, it can't be taken out.

[yorkieme in reply to PMRpro]

Hi' Just read your post and wondered if you have any advice/opinion reference my situation please. Back in March I broke a tooth but it left a sharp edge so of course my tongue catches it leaving me with sores for most of the time.(then came lockdown 23/03)

I have been to the dentist and he ground the sharp edge but clearly I need the tooth out.He told me they are only allowed to carry out certain procedures and that meant at the time no extractions. Since then I have started AA so does this mean that I cannot have an insert ?

If not then why not ?

Many thanks for your time.Hope OH is doing well and not draining your battery too much.

Just a quick response to the bit of humour by D.L. yesterday regarding Yorkshire men or Scots and money,we Yorkies are the most generous in spirit and all things material and when we give we give everything,unreservedly ................ so it must be the Scots who are tight fisted.lol. Have a nice week end.

[PMRpro Ambassador in reply to yorkieme]

No, no, Aberdonians ...

You mean you would consider an implant to replace the tooth? You may find it difficult to find a dentist who will do it now you are taking a bisphosphonate - one of their potential adverse effects is to cause avacular necrosis (avn) of the jaw. I'm not sure of the mechanism but avn is due to reduced blood flow to the bone and so it starts to die off. They seem to think that this is more likely if they do invasive dental procedures such as extractions if the tooth socket then doesn't heal properly.

But you need to get back to the dentist - my daughter's dentist (in Scotland) is working again so it is possible. I don't understand it - our dentists here in northern Italy have worked all the way through Covid, for the first month just dealing with emergencies but after that back to normal. As my dentist said, they clean the room after every patient anyway and always use PPE, they are used to it. There are a few things that are different - only the bare minimum of equipment is set out with only what instruments will be required for that patient but the treatment is the same

At the very least you need to discuss what you intend doing with this tooth longer term. It is possible they would do it more willingly if you stopped AA immediately. And that could be done on the phone in the first instance.

[yorkieme in reply to PMRpro]

Thank you,as you say I need to speak to my dentist and get an update on advice.It must be four weeks since my previous appointment and he explained back then that the restrictions were to do with any equipment that created spray.

[PMRpro Ambassador in reply to yorkieme]

Yes, aerosol production - but they obviously found an acceptable way to deal with it here!

[DorsetLady PMRGCAuk volunteer in reply to yorkieme]

I worked with a Yorkshireman for a long time - and he always referred to his Yorkshire Thumb (grips the wallet so tightly it can’t be opened!)... and always reckoned Scots were generous compared to Yorkies (his words not mine).

I’ll retreat to Pilates before further comment!

[yorkieme in reply to DorsetLady]

Bless him,there are exceptions to every rule but I have to confess that during my lifetime to date I have known one or two tykes with short arms and deep pockets.I lose either way,my mothers family one generation removed born and bred in Edinburgh and surrounding areas while my fathers family from the Waterford/Wexford areas in Ireland. I hope you are having a happy day,a big thank you from me for the time that you spend responding to and helping those of us who look to this forum.

[PMRpro Ambassador in reply to yorkieme]

No - Edinburgh is OK, Aberdeen has the Scots with tight fists ...

[DorsetLady PMRGCAuk volunteer in reply to yorkieme]

Actually he was always saying that, but he’s wasn’t in the least stingy!

Maybe perhaps because he was living outside Yorkshire - in deepest Dorset at that time - he felt he had to maintain the perceived opinion of Yorkshire folk!

As for my help, you’re very welcome - much like PMRpro says, it’s our way of giving what we can to the Charity.

There are no shops to volunteer in, and I’m not one for running the marathon, but this is what I do because I enjoy it.🌸...and hope it stops others suffering as I did, but unfortunately that still seems to happen.

[HamishPMR in reply to yorkieme]

Really sorry, I cannot help.

[ignatz]

Have you found this official advice... "Risk level For patients taking anti-resorptive drugs for the treatment of osteoporosis or other non-malignant diseases of bone, the risk of developing this side effect is between 1 in 1000 and 1 in 10,000." sdcep.org.uk/wp-content/upl...