Dental care while on Zometa?

Hi everyone,

I was wondering if anyone has had their teeth cleaned or had procedures done at the dentist while on a biophosphonate such as Zometa. I know there's a danger of jaw necrosis if invasive work is done but I haven't been to the dentist in 2 years and need to have a cavity filled. I'm a little apprehensive about going. Any feedback on this situation??

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  • I was just put on Zometa in October, but my Oncologist told me to go to the dentist prior to my first infusion, just to make sure I wouldn't need any invasive dental work once I was on it. And admittely, I am a dental fenatic...I go twice a year or more without fail. But apparently the potential of jaw necrosis is taken very seriously because my dentist still added to two of my fillings that were otherwise fine, just to be absolutely sure. I know it's a bit late now, but I'm wondering what your dentist's opinion is, and whether or not the risk is substantial enough to go off of the Zometa long enough to get the work done.

  • I take Xgeva and had to go off it for a few months for some oral surgery due to an infection that would not clear up. I also went off Afinitor but stayed on Letrozole. I now see the dentist or periodontist every 3 months for cleaning. I keep my oncologist informed of every procedure and he too is concerned about the potential of jaw necrosis. But the jaw is fine...it was more of the soft tissue in my mouth. Being off the Xgeva and Afinitor for a few months was great, I must say! But, I wouldn't want you to go through what I did with this infection that was at the roof of my mouth. Hope my little story helps!

  • I go for fillings and cleanings. You have to maintain your teeth. Make sure your dentist is aware of your condition

  • Thanks for the info! I'm on Zometa and wasn't aware of this...

    - 😀

  • Definitively get your tooth filled, go for regular cleanings and maintain dental hygiene in order to avoid the really invasive work. I have been on Zometa for 7 years (every three months). Unfortunately, I had to have a root canal for infection and eventually a tooth extraction a couple of years ago but my dentists and oncologist stayed in touch and made sure I was ok. I chose a "flipper" to replace the tooth to avoid an implant. Letting teeth problems get worse is far worse than avoiding treatment now. I have no necrosis but my dentist is aware to look for early signs and start early treatment. Take care of your teeth.

  • Hi Kats3!

    I go to the dentist every 6 months. My onc wants me to go to make sure everything is okay. My understanding is that having cavities filled are okay. You just can't have anything done more invasive than that. Before any other surgery, you have to be taken off of the Zometa for a month or two. Check with your onc to be sure.

  • Routine dental care is okay and should be done. Unfortunately, I had a tooth go bad while on Xgeva(alternative to Zometa). Root canal did not work. I ended up with osteonecrosis of the jaw. No more bone strengthening meds for me.

  • No I have not. As soon as my dentist and I met at our first screening he told me all about what the wonderful biphsophonates do to the bone. I provided him my oncologist phone number. I was not put on those drugs but put on Xgeva that as it turns out is just as tricky. You need to tell your dentist your cancer history as well as chemo, past treatment and current treatment. My dentist has made the impression on me that 6 month cleaning and annual exams are vital importance while on these drugs. He incourges me to always floss and talk to him and my oncologist about any concerns with my teeth. He indicated that he would not preform anything more than cleaning and exams without talking to my oncologist first. I was also told that I would have to be taken off the medication for about a month if larger procedures are necessary. My dentist would not fill cavities, pull teeth or do major work on teeth without approval from my oncologist to make sure my condition is okay for these types of procedures. Your first step is to talk to your oncologist especially if you are experiencing jaw pain. I believe, I could be wrong but, this may be the only way with your oncologist referring you to the dentist due dental issues while on the medication that it might be possible for insurance to cover intervention from a dentist, if it is found your issues stem from drug complications. It is imparitive on many levels to have open discussions with both your oncologist and dentist. Good luck to you.

  • Thank you everyone for your input about having dental work done while on a bone strengthener. I kind of thought that big procedures are a no no. I'll clear it with my Oncologist. I think I 'll be safe having a cavity filled, and also cleanings. I'm way overdue! I know that I need a root canal but the tooth isn't bothering me right now. I hope I can get it tended to in the near future. Thanks again everybody!

    Kats3

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