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Dental work while on Reclast

Osteoporosis & Bone Health | Last Active: Oct 22 7:01am | Replies (161)

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@hlp123

Dear Lori,
Thank you so much for your reply ! I plan to call my oral surgeon by Tuesday and inform him of the fact that I have had Shingles. I do not have any remaining symptoms except itching and some residual pain on my breast and under my arm where the blisters were the last to appear. I do not feel any tenderness in my jaw. My cheek on the side where my ear pain was so severe feels slightly numb, but not tender. I am so worried that the surgeon will decide to postpone the extraction, but I know I must give him the information he will need. I asked for instructions about how to prepare for the extraction when I was there for a consult and they said there were no instructions. I wonder about the fact that the denture has been sealed in a bag for several months. This seems as though it will not be good for the placement. I will ask if it should be "soaked" or something. They said to just bring it with me when I come for the extractions. I saw a specialist at the ear clinic on Thursday to have my ear examined. There have never been any visible blisters near my ear. The doctor said there is no sign of anything wrong with my ear. I worry about the trigeminal nerve being involved, but I did not get any answers. So the Eye doctor says my eye is ok, and the ear doctor says my ear is ok, so then why was I in severe ear pain until I got antivirals ? I am trying to not worry. I know that is not good for Shingles. I do like to get clear answers and clear cause and effect explanations, but I feel as though I don't understand most of what my situation is. My Dear Lori ! you are the only one I understand and who answers my questions ! Would you send me a list of what you would tell the oral surgeon and what you would ask him. You are such a blessing ! I am so grateful for your help. Thank you

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Replies to "Dear Lori, Thank you so much for your reply ! I plan to call my oral..."

Hi Holly! I’m sitting here on the couch, curled in a blanket, with a hot cup of tea this morning. I don’t know where you are but I live in the north woods of Wisconsin and my gosh, we have the fireplace going! It was 34 degrees when I got up this morning…on June 10!!! What the heck! So get comfy with me and let’s chat about the big adventure coming up for you!

First let’s talk about the oral surgeon appt. My gut feeling is that this project will be a ‘go-ahead’ for the 17th so you can be all smiles!! By that time you’ll be 1.5 months past the initial shingles onset, you’re taking antivirals, no new blisters and you’ve been cleared by 2 doctors. The pain symptoms are waning and you don’t have any pain in your jaw, so it doesn’t seem like there’s any reason not to go ahead. But I’m not a dentist so it’s important to still call ahead to the OS office.

Obviously I haven’t seen you in person, but from what we’ve discussed, I believe those 4 remaining teeth are what’s referred to as simple extractions…meaning they should be easily removed with no complications. So I don’t anticipate your having any issues with the procedure. Also, where these teeth are located, there shouldn’t be any impact from the local anesthetic and not near the trigeminal nerve area. You’ve had numerous teeth extracted before, these should be easy peasy. This won’t be any different that what you’re used to except that you’ll have a new smile when you walk out of the office. ☺️

What your oral surgeon will tell you is to not remove the plate for 24 to 48 hours. That’s to stop any bleeding and to prevent any swelling that might interfer with the denture fitting the next couple of days. It also helps the newly healing tissue to conform to the shape of the denture.
It’s a lot to get used to though, so….shhh… it’s ok after a few hours to remove it for a COUPLE MINUTES ONLY, rinse it off and reinsert it. Gives you a little break. But if you can keep it in full time it’s the best.

The biggest adjustment will be with the denture itself. It’s new and takes getting used to, physically, mentally and visually. You’ll likely have excess saliva and maybe even feel a little gaggy. Your general dentist will see you in a couple days to check on the fit and can trim away any excess plastic that may be rubbing on gums or palate, or if it feels to ‘thick’ or full around your lips and cheeks. Your dentist will help you get the best fit. Remember, for the first 6 months there will be changes to the tissue and bone. So the denture may get looser as weeks go by. That’s where the adhesive will be a comfort fix. When your dentist feels the time is right, they will most likely do a relining with a new layer of plastic to conform to your mouth once it’s stable.

A reminder of a conversation we had a while ago, about removing and cleaning the denture. Make sure you fill your basin with water!! That way in case you drop your denture it doesn’t land in a porcelain sink and chip the teeth or crack the plastic. You can also get denture cleaning kits at a drug or grocery store. It’s a little plastic container where you can place the denture and add water/cleaning tablet to soak for a minute or so. Brushing with a regular toothbrush and toothpaste is fine too. Whatever works for you. It’s important to clean not only the teeth but to brush all the plastic, even in the inside of the palate.

The denture is basically a non-porous plastic and has been sealed in a baggie since October. It’s pretty customary that before placement it will be removed from that bag, soaked in an antibacterial solution and rinsed to make sure it’s been disinfected for you. They may also have you swish with an antibacterial product before you have the extractions.

So, this week, call your OS office.
1. You can say, I’m calling to confirm my appointment on June 17th.
2. Then add, “Oh, by the way, I wanted to mention that I HAD shingles in April and have been taking antivirals for over a month. There’s no evidence of infection and I’ve been cleared by my eye doctor and ear specialist. I’m assuming we can go ahead with my appointment?”
(Something like that. Don’t be timid about it, just state as a matter of fact)

Other than that, Holly, I don’t know what else you’d need to ask at the appointment. You’ve had extractions before. This is only different because of the initial concern for being on Reclast. This is a very low risk procedure so that shouldn’t even be a worry at this point. You’ll get post extraction information and really, this should be a breeze for you. It’s the excitement and anticipation and anxiety for waiting all this time that has you feeling all heebie jeebie inside. Been a long time in coming! Try not to overthink this because you have good instincts and a great dental team between your OS and general dentist. You can ask them anything too. In our office we appreciated our patients asking questions instead of sitting in silence and worrying. But we wouldn’t know their concerns unless they’d tell us. Because even if we asked if they had questions, most would clam up until we got them talking! LOL. So try to relax and trust them, trust the process and you’ll be great!

I think you’re going to enjoy your new smile. As always I’m here if you have questions or concerns. Huge hug, Lori…now breathe!! Hehe.