Has anyone heard that dentist won't do tooth extrations if you are now or have taken fosamax?What can you do?

Question

My friend has a badly decayed tooth and is in a lot of pain but dentist won't pull because her jaw could rot out from fosamax.What can you do? I'm coming up on that age but now I think I'd be better off letting my bones turn to dust.

Answer 1

Several studies have linked Fosamax with problems involved in tooth extraction and jaw damage. The problem with fosamax is that in some cases people who take Fosamax and under routine procedures like tooth extraction suffer grievous injury because their bone fails to heal properly. There is no way I would extract teeth from patients taking fosamax because legal action can be filed against those responsible for jaw damage. Therefore, unless the patient stop taking Fosamax, it's my right to refuse the extraction, and refer the patient somewhere else.

Answer 2

I wrote this for another group. Maybe it will be of interest or value to you.
~~~~~~~~~~
Be aware of a few things. Osteonecrosis following tooth extraction is a known,
but very rare occurance for people taking bisphosphonate medications. Besides
Fosamax, as mentioned, other oral forms of bisphosphonates include Actonel,
Boniva, Didrohel and Skelid. There are also intravenous versions of
bisphosphonates that are used particularly in cancer patients. If you are using
one of these meds, you WILL know about it. The incidence of osteonecrosis is
much higher with the iv forms than it is with the oral forms and even then, it
has only been reported about 1% of the time. With oral forms, it is extremely
rare. Most cases reported have involved patients on long-term chemotherapy and
some were taking short-term steroids in addition to bisphosphonates.


Since the mechanism that causes this problem is not yet understood, it is not
clear how to best prevent problems following dental extractions. The better
route [pun intended] would be to avoid extractions by good dental care. If
possible, choose endodontic therapy (root canal treatment) instead of
extraction. If possible, have any elective dental extractions, such as wisdom
tooth removal, completed prior to initiating bisphosphonate therapy.
Paradoxically (to me), bisphosphonates may be a contraindication to the
placement of dental implants, because their placement involves creating a
surgical wound in the bone which might then lead to osteonecrosis.


I would not say that you can totally ignore the possibility of problems with
dental extractions and oral bisphosphonates, but it should be of minor concern.
As with any other procedure, you have to evaluate the risks vs. the benefits.
If you find yourself faced with the necessity of having a tooth removed, you are
already pretty far down the road with no alternate treatments to choose from.
Sometimes, you just gotta do what gotta do. Follow your post-extraction
directions perfectly. You do not want to get an infection (as if you would
otherwise, right?) as this increases the risks of osteonecrosis.


WHAT TO DO IN REAL LIFE:
1. Keep your teeth clean and watch you diet.
2. Always choose root canal treatment over extraction, if possible.
[1 and 2 apply to everyone every day anyhow.]
3. Inform your dentist with any change in medications, especially if you are
adding Fosamax, Actonel, Bonvia, etc., to your routine.
4. If you are faced with having an extraction, remember to remind your dentist
that you are on one of those meds. If s/he shrugs his shoulders, tell him that
you heard someone on Oprah talking about "those bone medicines and trouble
healing after an extraction." If s/he still seems unimpressed, ask if you might
be better off going to an oral surgeon.
5. If you are using an intravenous bisphosphonate, ask for a medical consult.
You will probably be very closely monitored by a medical team at this point
anyhow, but be sure that you are aware of the increased risks.

Answer 3

http://dentalimplants-usa.com/specialreport.html

Fosamax can cause Osteonecrosis of the jaw or the jaw bone to die! Typically, slight osteonecrosis occurs after injury to the jaw bone, and is most common following tooth extraction. Impaired wound healing can happen.

Answer 4

Fosamax is given in cases of osteoporosis, in which it help the bones to utilize the calicium in the body. Please let your friend consult another dentist.