Having extractions or anything that affect bone below the tooth puts you at a risk for jaw issues while taking Zometa. The dentist and hygienist can work with you before starting and during to minimize your risk of problems. Like anything, it is a cost vs benefit assessment for each of us. I love how our oncologist explains his reasoning for every recommendation. The thing that sold me was knowing the pain my husband had with a compression fracture. Every one of those takes away from his quality of life. If I can avoid that pain, I will.