Hello, I would appreciate some advice. I am 1 1/2 years in. I am taking 4-5 mg pred and Methatroxate. I also have an auto immune condition called absorption, where the body attacks the roots of teeth. My surgeon says I will need to discontinue taking fosmax for 4 months to extract a molar. I know how important it is to avoid infection so this has to be done. I have osteopenia and am concerned that discontinuing the fosmax for months will have a bad affect on my bones. Anyone know if I should be concerned? Thanks for your thoughts!
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Suzorand
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Did you have a bone density scan before Fosmax was prescribed and definitely have significant osteoporosis ? My DEXA scan was fine so I didn’t need Alendronic Acid. One of my anxieties about that drug was the negative effect it could have on the teeth and jaw. That is also in the side effects of Fosmax. I was told that I could stop AA at any time, I imagine Fosmax is similar but I would definitely have my my doctor’s guidance in order to do this. Everyone has a unique medical history. I haven’t heard of Absorption before. Does it have another name?
Thank you. Also I found Suzorand ‘s autoimmune disease under resorption. Personally, Suzorand, this would make me think long and hard about the wisdom of Fosmax. I expect you’ve had those discussions with your Rheumatologist.
No, I have not yet but I will be certain to discuss this at my next appt. A year and half ago my osteopenia was not too advanced but I fear that it will worsen with taking Prednisone. I am happy that I am at a very low dose now and trying to taper off slowly. I appreciate your knowledge and advice about the side affects of Fosmax drugs, which I will look into in depth. And yes the condition is resorption. Thanks
Loss of bone density is not inevitable when on pred - even without Fosamax. I have only taken 4 tablets of it but have been on pred for 12 years - my bone density has barely changed.
You say you have osteopenia - do you know what your dexascan results are, in particular the t-scores? Osteopenia is a broad church, running from almost normal to almost osteoporosis, so it makes a difference where you are on the spectrum. However - stopping Fosamax for a few months isn't likely to make much difference to the bone density as the effects persist and the substance remains in the bones indefinitely.
The Mayo clinic site says
"the bone-strengthening effects of bisphosphonates appear to continue for several years after people stop taking the drugs."
As AA can, all by itself, as has been noted, cause problems with the jawbone, I think you should not hesitate to discontinue this medication. You probably don't need to be taking it at all, and as PMRpro pointed out the substance remains in your bones indefinitely so you will not suffer any rebound problems as can happen with some of the bone drugs. There are a number of things which you can do to maintain and even improve bone density without drugs. Have a look at my story for some ideas for what you might consider:
Your write up was a shocker for me. I had a tooth that rapidly deteriorated due to internal Resorption. I had never heard of it before but had to have it pulled out so still empty hole since I couldn’t have implant. I was then told I had PMR. I thought it was connected some way to all the inflammation I was feeling but, until I read your post, didn’t know it was another autoimmune disease. Wow, that means it may keep going away at my teeth, right? No rheumatologist, GP or dentist has mentioned this being tied to autoimmune. Do you have any good info you’ve read on this resorption you can direct me to?
Per website “ Systemic sclerosis (SSc) is a complex, chronic, and progressive autoimmune disease. SSc causes bone resorption of mandible and distal phalanges of fingers through a known mechanism, and it has also been pointed out as a possible cause of apical root resorption of teeth, because tooth resorption is regulated by similar mechanisms to those controlling bone resorption. “
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