Alendronic Acid and dental work

[Buchanan16]

Hi lovely people my mum has been doing amazing and is currently on 6mg and doing well but she has had toothache for past week or so in one of her front crowns. We went to dentist last Friday and they xrayed and cldnt see any infection and said just to monitor it nut she's been up all night with the pain.

The dentist obviously knows she's on Alendronic Acid but she's terrified they won't be able to do anything for it.

Has anyone had dental work done while taking it and what does it mean.

She is a fainty person and panics at first sign of anything wrong and I'm not sure how to reassure her.

Can dental work be done while taking Alendronic Acid and how does it affect any work needed.

Thank you for all your wise words and advise.

[PMRpro Ambassador]

The non-healing problem with bisphosphonates is mainly associated with invasive dental work - extractions for example - but it is extremely rare with tablets and still rare with infusions as used in rheumatology. The cases are seen in oncology patients where they get up to 17-20 times the dose by getting infusions every 3 or 4 weeks and where there is also the underlying cancer pathology to consider too.

Removing and replacing a crown, even though drilling may be required, shouldn't pose a problem. Care and close monitoring afterwards also removes some of the small risk with extractions.

[Buchanan16 in reply to PMRpro]

Thank you so much for your prompt replyand hopefully that will put her mind at ease for now. We have an appointment at dentist tomorrow and he is really good and knows mums history.

[Buchanan16 in reply to PMRpro]

I'm just wondering my mum is really nervous about her dental appointment today and she says she feels funny a bit seedy and butterflies in her tummy which isnt unusual when she gets worried about anything.My question is should she be taking any extra pred especially if dentist does have to do any work on the tooth. As she is only on 6mg pred and due to start taper to 5 1/2 on Friday I don't want her adrenals causing any issues.

She has always been a nervous person and been known to faint when she gets herself into a state over something which obviously I don't want at dentist.

She has it into her head that they won't be able to do anything because she's on alendronic acid despite my reassurances that they will as long as they know and take necessary precautions.

I've done okay up till now but coming into where adrenals start to wake up I must admit I'm feeling bit out my depth as not sure I totally understand it all myself.

Apologies I went of track a bit there its been a rough few weeks for me with my husbands health and I was just so glad my parents were OK as I had enough to deal with so I'm just hoping all goes well today.

Thanks again for listening.

[DorsetLady PMRGCAuk volunteer in reply to Buchanan16]

If dental visit is in the offing, I’d hold back on the Pred reduction until that’s done and dusted…

[Buchanan16 in reply to DorsetLady]

So don't increase just hold of at 6mg for another week or so?

[DorsetLady PMRGCAuk volunteer in reply to Buchanan16]

Yep... that's what I'd do if in your mum's situation... hope all goes well for her.

[Buchanan16 in reply to DorsetLady]

thank you

[PMRpro Ambassador in reply to Buchanan16]

Yes, at least. And giving her an extra bit of pred won't hurt her but might help calm her down.

[Pixix]

Yes, I did, but mine was all related to dental infections in a large back tooth.

[Amber1414]

I took that horrible drug and as of now have lost 7 teeth, 2 of those still have the roots in the gum because the teeth broke off at the gum line! My dentist told me that my teeth turned to chalk basically. Now, at 67, I am supposed to magically come up with 30-40 k which will never happen. There is no reversing the damage once it takes place so I just wait for the next one to break off or fall out.

I am actually going to Mexico to have my dental work done because it is so affordable. I wish you luck.

[PMRpro Ambassador in reply to Amber1414]

If teeth are breaking off and it is being blamed on hypomineralisation then it is unlikely that alendronic acid was the direct cause. You may have developed acid reflux which is a common cause of hypomineralisation - or another cause is drinking too much orange juice, especially if you hold it in your mouth. But you cannot blame AA for it without a lot more proof.

medlandorthodontics.com.au/...

[Amber1414 in reply to PMRpro]

I took Fosamax for 7 years, not AA, I mis-spoke. I am not guessing that the Fosamax was the cause, it was diagnosed by my dentist, my TA doctor and my GP. I was left on the medicine far too long but it didn't help anyway. I had to have my hip replaced after the socket basically dissolved and fractured both bones in my right ankle simply playing with my grandson in a field across the street from my home.

I have never had acid reflux, upset stomach, etc. My enamel on my teeth is fine.

[HeronNS in reply to Amber1414]

Fosamax is, I think, a brand name of alendronic acid.

[PMRpro Ambassador in reply to Amber1414]

Fosamax is indeed the brand name for alendronic acid. In the USA you always refer to medications by brand names, in the UK we mainly use the substance name as that never changes and reduces confusion.

[Pollyone]

hi

I asked my very senior dentist as I didn’t want to take AA knowing I needed dental treatment but my Dxa bone scan necessitated it recently. He was relaxed about it and not unduly concerned. I think length of time on it and whether extraction needed comes into play but it’s not the terrible problem I tnought. (Had extraction prior to takingAA). Every case different of course dependant on treatment. He did say the 70mg dose was low as per Dorset lady’s response.

Wish your mother the best.

[Menno1525]

My dentist wanted to get my bridgework done before I started on AA ( in fact I never did) due to the healing issues that occur with AA. As it was we went ahead and got it done. However as someone who does suffer from medical anxiety esp with dentists, it really helped that mine , a really nice man, was happy to do the work in shorter sessions and with me being a bit more propped up rather than standing on my head! It also helped that my GP was willing to prescribe me a one off dose of Valium ( I only took 2mg) which was just enough to take the edge off and enable me to stay still and calm for an hour at a time. Great success given the panic attacks I had on earlier attempts. BTW might be worth asking them not to use anaesthetics containing adrenaline as if your heart rate is up already it can really send you into overdrive and panic.

[AtopicGuy]

I suffered tooth sensitivity when on steroids, despite brushing twice a day with an anti-sensitivity toothpaste. So I now dissolve a pea-sized blob of the same Sensitive toothpaste in a small medicine bottle and rinse with it between meals. Does the trick.