root canal work while on zoledronic acid infusions

[Angel_doll]

I have 6 monthly dental checkups, and for years all has been well. I had my first zoledronic acid infusion 28th December 2023. My last dental checkup was in March. A week ago I started getting intermittent pains in the right side of my jaw, both bottom and top. GP ruled out PMR and recommended I visit my dentist. She favours an abscess, although nothing showed on the X-ray. She assures me that an abscess can cause referred pain such as I have described. She has prescribed a week of antibiotics and I will see her again in 2.5 weeks. If it is an abscess she is recommending root canal treatment.

So, questions. Has anyone experienced anything similar? What special considerations are there regarding bisphosphonates and root canal work? Should I push for a referral to maxillofacial? Anyone any ideas on what else could be causing this pain? Oh, and the only painkiller I can really tolerate is paracetamol. Any suggestions for alternative remedies to quieten down the pains when they get too bad?

Thank you in advance.

[PMRpro Ambassador]

Root canal treatment is preferable to the alternative of extraction in patients on bisphosphonates

"Root canal therapy can delay, or even eliminate, the need for tooth extraction, and therefore, may reduce the risk of bisphosphonate-related osteonecrosis of the jaw. We suggest that this might be the best treatment for teeth with pulpal and/or periapical disease."

ncbi.nlm.nih.gov/pmc/articl....

As to the cause of the pain - can't really comment there but if it is an abcess, it will certainly cause referred pain. I assume she would see avascular necrosis on the x-ray.