1. < Osteoporosis & Bone Health

Dental work while on Reclast

Posted by hlp123 @hlp123, Oct 4, 2022

I had an infusion of Reclast in March 2022 as a transition drug to stop taking Prolia. I had a tooth break off at the gum last week and saw an oral surgeon yesterday and he said he needs to remove the root of the tooth before it becomes infected. Has anyone had invasive dental work, such as this while on Reclast ?
Please let me know about your experience.
Thank you,

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

leejoan5525 | @leejoan5525 | Sep 10 6:36pm

My endocrinologist says there shouldn't be any problems but the surgeon won't budge. I look horrible,am embarrassed to be around people. There is physical health to consider, but mental health as well. I have no other dentists to go to where I live because they won't accept my insurance.

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Mentor
Lori, Volunteer Mentor | @loribmt | Sep 11 9:11am
In reply to @leejoan5525 "I had the reclast last May. The oral Surgeon and the endocrinologist were supposed be in..." + (show)
@leejoan5525

I had the reclast last May. The oral Surgeon and the endocrinologist were supposed be in contact and I was assured that I could go ahead with the reclast and it wouldn't cause any problems with dental extractions. Then they oral surgeon said no and the plan is to pull teeth one by one as they become infected and cause pain. I just can't believe this is a valid alternative. I am sick about it, in tears just typing this comment.

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Hi, @leejone5525. I’ve read through your posts this morning and I’m just so sad for you with what you’re going through with your oral health. I worked in the dental field as a certified dental assistant for 30+ years and with what you’re telling me, there has to be more to this story. It doesn’t make sense that an oral surgeon would wait for each one of your remaining teeth to become infected before considering a removal.
Risk of infection is what an oral surgeon would want to minimize with any extraction. So having an active infection can potentially compound the risk for improper healing. And waiting for each one in turn, instead of removing several at one time, seems highly unusual.

As you’ve probably read with some of the other posts in this discussion, there is a very slight risk of an infection (osteonecrosis) to the bone while on Reclast or other bone loss medications. That can be a reason to postpone or delay dental treatment. However, the possibility of a systemic infection with your deteriorated teeth pose more risk than the extraction process. With proper pre-extraction precautions such as oral anti-bacterial rinses and possibly prophylactic antibiotics the risk of infection with your extractions could be minimized. Did your oral surgeon give you a reason for waiting until each tooth was critical before removing? I agree with you, that would have me in tears too!

You mentioned not being able to find another oral surgeon who can help you because of insurance. Not all extractions require an oral surgeon. There are many general dentistry offices which can offer extractions along with denture replacement so that might be an option for you. You mentioned being in the Eau Claire area.
Here is the site for the Wisconsins Department of Health Services which shows the dentists who accept Medicaid. Other options if your insurance won’t cover is to set up payment plans for services.
https://www.dhs.wisconsin.gov/guide/freedental.htm.htm
Do you have a general dentist?

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2 replies
klorer | @klorer | Sep 11 9:44am
In reply to @loribmt "Hi, @leejone5525. I’ve read through your posts this morning and I’m just so sad for you..." + (show)
@loribmt

Hi, @leejone5525. I’ve read through your posts this morning and I’m just so sad for you with what you’re going through with your oral health. I worked in the dental field as a certified dental assistant for 30+ years and with what you’re telling me, there has to be more to this story. It doesn’t make sense that an oral surgeon would wait for each one of your remaining teeth to become infected before considering a removal.
Risk of infection is what an oral surgeon would want to minimize with any extraction. So having an active infection can potentially compound the risk for improper healing. And waiting for each one in turn, instead of removing several at one time, seems highly unusual.

As you’ve probably read with some of the other posts in this discussion, there is a very slight risk of an infection (osteonecrosis) to the bone while on Reclast or other bone loss medications. That can be a reason to postpone or delay dental treatment. However, the possibility of a systemic infection with your deteriorated teeth pose more risk than the extraction process. With proper pre-extraction precautions such as oral anti-bacterial rinses and possibly prophylactic antibiotics the risk of infection with your extractions could be minimized. Did your oral surgeon give you a reason for waiting until each tooth was critical before removing? I agree with you, that would have me in tears too!

You mentioned not being able to find another oral surgeon who can help you because of insurance. Not all extractions require an oral surgeon. There are many general dentistry offices which can offer extractions along with denture replacement so that might be an option for you. You mentioned being in the Eau Claire area.
Here is the site for the Wisconsins Department of Health Services which shows the dentists who accept Medicaid. Other options if your insurance won’t cover is to set up payment plans for services.
https://www.dhs.wisconsin.gov/guide/freedental.htm.htm
Do you have a general dentist?

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I had a very good dentist and he retired and I do have osteoporosis and could not take Fosamax 🙁
Could not increase calcium due to kidney stones from Calcium and
am lactose and gluten intolerant

REPLY
2 replies
klorer | @klorer | Sep 11 9:46am
In reply to @klorer "I had a very good dentist and he retired and I do have osteoporosis and could..." + (show)
@klorer

I had a very good dentist and he retired and I do have osteoporosis and could not take Fosamax 🙁
Could not increase calcium due to kidney stones from Calcium and
am lactose and gluten intolerant

Jump to this post

May have been a different post as I very recently connected to this site . Thank you 🩷

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Mentor
Lori, Volunteer Mentor | @loribmt | Sep 11 10:18am
In reply to @klorer "I had a very good dentist and he retired and I do have osteoporosis and could..." + (show)
@klorer

I had a very good dentist and he retired and I do have osteoporosis and could not take Fosamax 🙁
Could not increase calcium due to kidney stones from Calcium and
am lactose and gluten intolerant

Jump to this post

Welcome to Connect, @klorer. Osteoporosis seems to be a common theme when we become ‘women of age’. 😉
Bone loss supplements can be a huge assistance to help prevent fractures, especially in the fragile vertebrae.

If you’re not able to take bone loss medications, it doesn’t leave you out in the cold. There are targeted exercises and weight bearing exercises that can help keep your bones healthy. Also, being lactose intolerant should no longer stop you from getting benefits from dairy products. I’m lactose intolerant and eat Greek yogurt daily, along with drinking Fairlife milk. The milk is naturally lactose free and has a high protein level. There are other lactose free products on the market like cottage cheese and ice cream. The process of aging cheese and making yogurt also neutralizes the lactic acid. So, people with lactose intolerance can tolerate those products very well.

You’ve been diagnosed with Osteoporisis but can’t take supplement. Has anything been suggested for you in terms of diet or exercise? Have you been seen by an endocrinologist?

REPLY
janflute | @janflute | Sep 12 7:24am
In reply to @justinesmith "I took Reclast 2 and 1/2 years ago (one infustion) for osteoporosis and had an extraction..." + (show)
@justinesmith

I took Reclast 2 and 1/2 years ago (one infustion) for osteoporosis and had an extraction of tooth number 14. It became infected and there was an overgrowth of tissue. The oral surgeon removed the tissue and prescribed antiobotics. Number 15 was already missing and one of the lower teeth on that side was missing. I inquired about an implant of number 14 because it is now hard to chew. The dentist (it is a dental school) said no implant because Reclast has a half life and no more extractions because the last one was slow to heal. My osteoporosis doctor said an implant is ok. I also have cll which might make me immune ompromised so it could slow down healing. My other options are to do nothing, have a partial which is removable or go see another dentist who might do the implant. any ideas of how to proceed?

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Can you have tooth extractions and implants if you are taking Fosomax? Is it the same drug as Reclast but administered in smaller doses?

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Mentor
Lori, Volunteer Mentor | @loribmt | Oct 19 8:37am
In reply to @hlp123 "Dear Lori, This sounds like a sensible plan. I appreciate your empathy with my situation. As..." + (show)
@hlp123

Dear Lori,
This sounds like a sensible plan. I appreciate your empathy with my situation. As you well know by now, I tend to overthink things and then I get anxious. I'm working on recognizing the "what If's" and trying to relax.
You are the Best !
Holly

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Hi Holly! @hlp123 My spidey sense has me feeling it’s time to check in on you! ☺️ I hope all is well!
How’s life with the new dentures? Have you gotten used to your new smile?

REPLY
leejoan5525 | @leejoan5525 | Oct 21 3:31pm
In reply to @loribmt "Hi, @leejone5525. I’ve read through your posts this morning and I’m just so sad for you..." + (show)
@loribmt

Hi, @leejone5525. I’ve read through your posts this morning and I’m just so sad for you with what you’re going through with your oral health. I worked in the dental field as a certified dental assistant for 30+ years and with what you’re telling me, there has to be more to this story. It doesn’t make sense that an oral surgeon would wait for each one of your remaining teeth to become infected before considering a removal.
Risk of infection is what an oral surgeon would want to minimize with any extraction. So having an active infection can potentially compound the risk for improper healing. And waiting for each one in turn, instead of removing several at one time, seems highly unusual.

As you’ve probably read with some of the other posts in this discussion, there is a very slight risk of an infection (osteonecrosis) to the bone while on Reclast or other bone loss medications. That can be a reason to postpone or delay dental treatment. However, the possibility of a systemic infection with your deteriorated teeth pose more risk than the extraction process. With proper pre-extraction precautions such as oral anti-bacterial rinses and possibly prophylactic antibiotics the risk of infection with your extractions could be minimized. Did your oral surgeon give you a reason for waiting until each tooth was critical before removing? I agree with you, that would have me in tears too!

You mentioned not being able to find another oral surgeon who can help you because of insurance. Not all extractions require an oral surgeon. There are many general dentistry offices which can offer extractions along with denture replacement so that might be an option for you. You mentioned being in the Eau Claire area.
Here is the site for the Wisconsins Department of Health Services which shows the dentists who accept Medicaid. Other options if your insurance won’t cover is to set up payment plans for services.
https://www.dhs.wisconsin.gov/guide/freedental.htm.htm
Do you have a general dentist?

Jump to this post

Thank you so much for your ideas and help. Part of the problem is that Wisconsin still has not accepted the Medicaid expansion so Medicaid only pays about 1\4 the actual cost. The dental offices only take a small number of Medicaid patients and stop taking new patients. I got on a waiting list for the dental clinic at the tech school and after 6 months, I was able to see a dentist.

I am also on a waiting list for the Oral/Maxillofacial Department at Mayo in Rochester. Hopefully something will work out. I have pulmonary hypertension and I have been told to to be very careful of my oral hygiene as an infection could be serious.

REPLY
millerint2 | @millerint2 | Oct 21 3:38pm

I have lost 2 molars on my upper right side of my mouth in the past 3 years… that is how long I have been on Reclast. I have one Reclast infusion/ year. I had no idea there could be a connection! My lower back is very painful, I have osteoporosis and arthritis! Trying to ignore it! I am 72 years old.. have always been very active and taken great care of my teeth.

REPLY
1 reply
leejoan5525 | @leejoan5525 | Oct 21 7:36pm
In reply to @millerint2 "I have lost 2 molars on my upper right side of my mouth in the past..." + (show)
@millerint2

I have lost 2 molars on my upper right side of my mouth in the past 3 years… that is how long I have been on Reclast. I have one Reclast infusion/ year. I had no idea there could be a connection! My lower back is very painful, I have osteoporosis and arthritis! Trying to ignore it! I am 72 years old.. have always been very active and taken great care of my teeth.

Jump to this post

4 medications that I take cause
dry mouth. Dry mouth is a total tooth killer. I got a portable water pick that I use all the time to irrigate. I am 70 and live in a senior building. Everyone walks around in pain from arthritis. They really don't have a good medication to treat arthritis. Someday.

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