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Dental work while on Reclast

Osteoporosis & Bone Health | Last Active: May 20 1:42pm | Replies (80)

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@loribmt

Good morning. ☺️ I just reread your post to make sure I cover all the points.
First, you have a very good oral surgeon. He is really doing his best to make sure your mouth heals well and that there are no side effects from the extraction. That he felt you could have the remaining extractions in 2 weeks if you choose to, is a good sign.
It’s pretty normal not to require a followup appointment for what’s referred to as a ‘simple’ extraction; meaning there were no complications and the tooth took minimal effort to remove. If you had unusual pain or bleeding, then that would be different. But your case sounds as though this was exactly as he anticipated.

Your next step will be to visit the new recommended dentist. He/she will do an oral exam and possibly take some impressions of your mouth, (study models) if not at that first appointment then at a later date. This gives the dentist the opportunity to do a work up plan for your dentures.

The pain in your lower jaw in the back, as I mentioned yesterday might be from having your mouth open during the extraction. Our jaw muscles aren’t used to stretching open for long periods of time. I have the same problem if I have a long procedure done. So here is a little trick I would tell patients who were having an upcoming dental appointment.

Simple opening and closing mouth exercises with tongue on roof of mouth can help prepare for the dental appointment so you can get through the appointment without too much problem.
Open your mouth with tongue on roof of mouth for 5 seconds then close. Repeat this for a minute. Only 5 seconds at a time.
That means you should be able to do 10-12 repetitions of 5 second holds in one minute. Try doing this more often and a little longer as the dental appointment comes near and the day of your appointment. Helps to stretch. And may help relieve your already sore jaw.

Also, you are now only using your front teeth to chew. So that can add more pressure on your TMJ (your jaw joint). A few exercises you can try when you’re not in too much discomfort:

First, place your thumb on the bottom of your chin and press up using moderate force. Open and close your mouth up to 10 times. You may notice small popping or clicking — stop if the movement is painful.

Using equal force, put your thumb on the front of your chin and press backward, moving it like you’re opening and closing a drawer.

I know you’re not considering getting any more treatment soon. But, it would be in your best interest to have that upper denture done sooner than later. There are several reasons for doing so, but one of the most important is this; By having a full mouth of teeth again, you might find that your jaw/joint pain goes away. With putting all the pressure on the front of the mouth for chewing in moves the muscles in the jaw unnaturally.

Ok, that’s enough information to chew on for now. Hehe…pun intended! I really do concur with the oral surgeon for you to see the denture specialist and have your mouth evaluated. That dentist will present your options and then at least you’ll have a plan. How’s that sound?

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Replies to "Good morning. ☺️ I just reread your post to make sure I cover all the points...."

Thank you so very much for all of this very helpful additional information !!!!! I am so very lucky to have you as a resource !!!! I will absolutely do the exercises that you suggested. How wonderful to have the information to address a situation before it becomes a problem.
My main concern is that I received the infusion of Reclast in March. I do not intend to get any more Bisphosphonates, if I can help it but I am still concerned about this possibility of necrosis. Using the guide of whether or not I have pain seems to be the only indication the dentist is using as to whether the bone has healed. Is this adequate ? or normal ? Also recommending that I can go forward with having the remaining four teeth removed in two weeks seems very soon. I am no expert, but I have read that there is no assurance that the bone has healed after a root extraction while on a bisphosphonate until there are no symptoms at the eight week point. I hear your advice and concern about the pressure that I am forcing my four teeth to take on. I agree it would be much better to relieve the pressure and prevent the remaining four roots becoming infected, but for now I am leaning toward being very conservative. I am being very careful about eating only soft foods and maintaining good oral hygiene.
I hope that this "Denture recommended doctor", has experience treating patients who are taking bisphosphonates. I promise to keep you up-dated, and reach out for your calm, thorough information.
You are absolutely correct, that it will be a huge relief to have a plan going forward that I can follow with confidence. Thank you so much !!!!!!!