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,

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@hlp123

Dear Loibmt,
I'm sending a big hug right back to you ! Thank you, for responding and for your thoughtful comments ! I do feel overwhelmed most of the time with dealing with my increasingly painful osteoarthritis and COPD. I am trying to address one issue at a time. I call it "Checking off each box" that I can and then move on to the next. I am grateful that I can, for the most part take care of myself. It is a real challenge that we live in a Colonial and the stairs are very difficult for me. We should have addressed "down sizing" years ago. I have an intolerance to steroids. I am very sensitive to all medications. My bp elevates to 220/130 for days. Even with medication. I can tolerate Tylenol. For now, the orthopedic surgeon that I saw on Wednesday has given me guidance as to what I need to do to find out if I qualify for shoulder replacement. This involves many tests and appointments, so it will be center stage for a while. However, I did have a successful yearly eye exam last week and I plan to have my remaining teeth cleaned soon. The denture specialist was not very positive about me having "a stable upper arch". You see, I did use your notes about questions I should ask the dentist. They were very helpful ! He is thinking about whether or not dentures would be successful. He promised to call me when he figured it out. He has not called me. So I will see him in person soon and ask what he thinks. Thank you, again for all of your support and expertise. It is such a comfort to know you are willing to help me! I will keep you posted. How wonderful that I can reach you in Wisconsin, from here in Detroit, MI.
Take care of yourself,
Many blessings !
Holly

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Oh my goodness, Holly, you’ve certainly got a lot on your plate right now. It’s difficult to process all of that on a daily basis, isn’t it? I know how overwhelming it seem when everything feels beyond your control…only so much you can accomplish in a day. I love your idea of checking off each box and moving on to the next in order to manage your day and pace yourself.

That reminded me of a discussion in our forum started a few years ago by a fellow mentor, @becsbuddy about the Spoon Theory, a means for getting through each day when you have limited energy. I’ve posted the link below where you’ll meet @becsbuddy @hopeful33250 @nana75165 and many other members who practice the spoon theory. ☺️

https://connect.mayoclinic.org/discussion/how-do-you-plan-your-day-and-conserve-energy-are-you-a-spoonie/

I think that’s a cool way to mete out time and energy in a day. But when I think of spoons, I think of food! 😂 So I have my own method for coping that keeps me away from the fridge!

Sounds like you’re getting good advice from your orthopedic surgeon and I hope you’ll be able to get your shoulder surgery taken care of soon. That seems like it’s the most pressing item to get out of the way! Getting a new shoulder can make a huge difference in your comfort level. A friend had a shoulder replacement not long ago and it was a game changer for her! She had range of movement again and little pain. The recovery period with PT wasn’t always pleasant but she said it was nothing compared to the pain she had before surgery. So she’s a happy camper.

I wish all the best for you and don’t hesitate to run ideas past me when you find out what your dentist came up with for a treatment plan.

We’re just across the big lake from each other! ☺️ Finally a gorgeous day in Wisconsin and not so oppressively hot & sticky! I tend to lose my cherub-like demeanor in that weather. Haha. Stay cool and keep me updated. Hugs! 💕

REPLY
@loribmt

Oh my goodness, Holly, you’ve certainly got a lot on your plate right now. It’s difficult to process all of that on a daily basis, isn’t it? I know how overwhelming it seem when everything feels beyond your control…only so much you can accomplish in a day. I love your idea of checking off each box and moving on to the next in order to manage your day and pace yourself.

That reminded me of a discussion in our forum started a few years ago by a fellow mentor, @becsbuddy about the Spoon Theory, a means for getting through each day when you have limited energy. I’ve posted the link below where you’ll meet @becsbuddy @hopeful33250 @nana75165 and many other members who practice the spoon theory. ☺️

https://connect.mayoclinic.org/discussion/how-do-you-plan-your-day-and-conserve-energy-are-you-a-spoonie/

I think that’s a cool way to mete out time and energy in a day. But when I think of spoons, I think of food! 😂 So I have my own method for coping that keeps me away from the fridge!

Sounds like you’re getting good advice from your orthopedic surgeon and I hope you’ll be able to get your shoulder surgery taken care of soon. That seems like it’s the most pressing item to get out of the way! Getting a new shoulder can make a huge difference in your comfort level. A friend had a shoulder replacement not long ago and it was a game changer for her! She had range of movement again and little pain. The recovery period with PT wasn’t always pleasant but she said it was nothing compared to the pain she had before surgery. So she’s a happy camper.

I wish all the best for you and don’t hesitate to run ideas past me when you find out what your dentist came up with for a treatment plan.

We’re just across the big lake from each other! ☺️ Finally a gorgeous day in Wisconsin and not so oppressively hot & sticky! I tend to lose my cherub-like demeanor in that weather. Haha. Stay cool and keep me updated. Hugs! 💕

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Thank you so very much for your reply ! Please know, that all of the information that you pass on is very helpful. I do tend to get overwhelmed and then try to avoid my situation, but I am so very encouraged to hear of the "spoon theory". You always provide me with a hopeful direction when I have hit a road block.
I know that I have a antibiotic resistant staph infection because I had a nasal culture done years ago. The orthopedic surgeon requested that I have another nasal culture done, so I am thinking this would be significant. I also get peri-anal abscesses every few months. Sometimes these will "go away" on their own and sometimes I have to take Doxycycline because they become so large and painful. One problem always seems to effect every other problem. Actually, I have found that eating raw garlic every day is a positive thing ! At least I have fewer outbreaks when I stay very disciplined and do this every day.
I will keep you posted. Thank you !!!!!
PS. I have not taken any more bisphosphonates. My year of Reclast infusion ended this March.

REPLY
@hlp123

Dear Loibmt,
I'm sending a big hug right back to you ! Thank you, for responding and for your thoughtful comments ! I do feel overwhelmed most of the time with dealing with my increasingly painful osteoarthritis and COPD. I am trying to address one issue at a time. I call it "Checking off each box" that I can and then move on to the next. I am grateful that I can, for the most part take care of myself. It is a real challenge that we live in a Colonial and the stairs are very difficult for me. We should have addressed "down sizing" years ago. I have an intolerance to steroids. I am very sensitive to all medications. My bp elevates to 220/130 for days. Even with medication. I can tolerate Tylenol. For now, the orthopedic surgeon that I saw on Wednesday has given me guidance as to what I need to do to find out if I qualify for shoulder replacement. This involves many tests and appointments, so it will be center stage for a while. However, I did have a successful yearly eye exam last week and I plan to have my remaining teeth cleaned soon. The denture specialist was not very positive about me having "a stable upper arch". You see, I did use your notes about questions I should ask the dentist. They were very helpful ! He is thinking about whether or not dentures would be successful. He promised to call me when he figured it out. He has not called me. So I will see him in person soon and ask what he thinks. Thank you, again for all of your support and expertise. It is such a comfort to know you are willing to help me! I will keep you posted. How wonderful that I can reach you in Wisconsin, from here in Detroit, MI.
Take care of yourself,
Many blessings !
Holly

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Dear Loibmt, I hope this up-date finds you well !!!
I have decided to go ahead with having the remaining five teeth In my upper jaw removed and getting dentures. I have just had my annual cleaning and the impressions taken for my upper denture. I am not sure at all that this is where I should be focusing my attention since I still have not had either of my shoulders replaced and my hips are very sore and I am still trying to find an inhaler that I am not allergic to that will address my COPD, but the dentist said my teeth are in such bad shape that they should be extracted and replaced with a denture. The plan is to have the teeth extracted in 2 weeks and then the denture put in place immediately. I am also dealing with Thrush that I have gotten from not rinsing out my mouth adequately after I use my inhaler. If you are still willing to walk me through this next part of my journey to address my health challenges I would sure love to have your input and support. I can't tell you how much I value your knowledge. I did have a hard time making the decision to get dentures or have my cataracts removed. Which to do first. I hope I made the right choice. I used your questions to ask the dentist and he said my "Upper arch" is not the greatest and I am going to have a real challenge getting use to the dentures. For now, I am not willing to get implants, because every rootcanal I had eventually ended up with an abscess. I seem to be very sensitive to medications and very prone to infections even though I am meticulous about hygiene.
If you are still willing !!! I look forward to hearing from you and thank you again for all of your help in the past. My year off of all bisphosphonates is over in March, 2024.
Bless you, Holly

REPLY
@hlp123

Dear Loibmt, I hope this up-date finds you well !!!
I have decided to go ahead with having the remaining five teeth In my upper jaw removed and getting dentures. I have just had my annual cleaning and the impressions taken for my upper denture. I am not sure at all that this is where I should be focusing my attention since I still have not had either of my shoulders replaced and my hips are very sore and I am still trying to find an inhaler that I am not allergic to that will address my COPD, but the dentist said my teeth are in such bad shape that they should be extracted and replaced with a denture. The plan is to have the teeth extracted in 2 weeks and then the denture put in place immediately. I am also dealing with Thrush that I have gotten from not rinsing out my mouth adequately after I use my inhaler. If you are still willing to walk me through this next part of my journey to address my health challenges I would sure love to have your input and support. I can't tell you how much I value your knowledge. I did have a hard time making the decision to get dentures or have my cataracts removed. Which to do first. I hope I made the right choice. I used your questions to ask the dentist and he said my "Upper arch" is not the greatest and I am going to have a real challenge getting use to the dentures. For now, I am not willing to get implants, because every rootcanal I had eventually ended up with an abscess. I seem to be very sensitive to medications and very prone to infections even though I am meticulous about hygiene.
If you are still willing !!! I look forward to hearing from you and thank you again for all of your help in the past. My year off of all bisphosphonates is over in March, 2024.
Bless you, Holly

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Hi Holly! Of course I’m still willing to help you! And I really feel that you’re making the best decision for your health by choosing to have your teeth taken care of first.
Your dentist stated that ‘your teeth are in bad shape’. Having worked all of my career in dentistry, I know that isn’t something a dentist says lightly. So it is in your best interest to go ahead and have those remaining teeth removed and replaced with the denture. You may even feel better when the infected teeth are removed and your gums no longer are harboring bacteria. That can make a huge difference in your overall health.

Considering that your teeth are most likely already loose these should be simple extractions and the concern over bisphosphonates would be minimal. So I think now just concentrate on trying to clear the thrush. A suggestion would be to eat a couple spoons full of plain yogurt daily. Let it wash over your tongue. It kills thrush. A medication I use can cause issues for me. So I eat yogurt right before bed.

Another trick is to Pull with organic, pure coconut oil. This also works as an anti fungal, antibacterial agent.
Take a good heaping teaspoon of coconut oil (solid) and put it in your mouth. Let it melt and then swish it around in your mouth for 20 minutes. Swish all over your tongue, checks, through your teeth, etc.. Do NOT swallow when you’re done. Spit it out in a tissue or waste basket. Coconut oil will clog the sink. This may help you get over your thrush faster and it really cleans the mouth and supports the tissue health.

That’s enough for today. When you’re ready I can tell you more about how the denture is made and what you can expect after placement. ☺️
Do you have any specific questions for me?

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Is Reclast or Fosomax a better choice (in regards to the jaw) for someone after two years on Forteo if they have had a history of root canals, an implant, and many fillings and crowns? I am 77.

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@janflute

Is Reclast or Fosomax a better choice (in regards to the jaw) for someone after two years on Forteo if they have had a history of root canals, an implant, and many fillings and crowns? I am 77.

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Hi @janflute. Reclast and Fosamax are both osteoporosis medications classified as Bisphosphonates. Fosamax is taken in pill form, while Reclast is an injectable.
Here is a comparison chart for both from Drugs.com where you can see them side by side:
https://www.drugs.com/compare/fosamax-vs-reclast

There have been reports of some people who take Fosamax, Reclast, etc., having developed a serious condition called osteonecrosis of the jaw, a condition in which bone tissue in the jaw dies, causing pain and the possible collapse of the jaw bone. This is why elective dental work is not recommended while on these medications.

However, it’s rare and the risk of osteonecrosis of the jaw is greater in patients who have received chemotherapy, radiation, or steroids. As a side note, it doesn’t mean the entire jaw is affected. This is generally localized to the area of treatment such as an extraction site. It can be treated and corrected.

It’s always best to discuss any dental treatment with your physician and dentist before undergoing anything invasive such as extractions and implants. They’ll come up with a plan to help avoid issues.

There shouldn’t be any issue with your current root canals, implanted tooth or fillings/crowns. The only consideration is keeping the bone strong to support your teeth. As with anything you have to weigh the risk vs reward.
I know this is a tough decision to make so best wishes going forward.

I just noticed another conversation in the forum regarding Reclast that you might be interested in joining…have you seen this one?

https://connect.mayoclinic.org/discussion/reclast-infusion/
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@loribmt

Hi Holly! Of course I’m still willing to help you! And I really feel that you’re making the best decision for your health by choosing to have your teeth taken care of first.
Your dentist stated that ‘your teeth are in bad shape’. Having worked all of my career in dentistry, I know that isn’t something a dentist says lightly. So it is in your best interest to go ahead and have those remaining teeth removed and replaced with the denture. You may even feel better when the infected teeth are removed and your gums no longer are harboring bacteria. That can make a huge difference in your overall health.

Considering that your teeth are most likely already loose these should be simple extractions and the concern over bisphosphonates would be minimal. So I think now just concentrate on trying to clear the thrush. A suggestion would be to eat a couple spoons full of plain yogurt daily. Let it wash over your tongue. It kills thrush. A medication I use can cause issues for me. So I eat yogurt right before bed.

Another trick is to Pull with organic, pure coconut oil. This also works as an anti fungal, antibacterial agent.
Take a good heaping teaspoon of coconut oil (solid) and put it in your mouth. Let it melt and then swish it around in your mouth for 20 minutes. Swish all over your tongue, checks, through your teeth, etc.. Do NOT swallow when you’re done. Spit it out in a tissue or waste basket. Coconut oil will clog the sink. This may help you get over your thrush faster and it really cleans the mouth and supports the tissue health.

That’s enough for today. When you’re ready I can tell you more about how the denture is made and what you can expect after placement. ☺️
Do you have any specific questions for me?

Jump to this post

Dear Lori,
Thank you so much for your response !!! I am so grateful that I have your wisdom to guide me. I have some good Greek Yogurt so after I read your message last night I followed your advice. I usually eat blueberries and yogurt every day because it is suppose to reduce inflammation. I will get some organic pure coconut oil as soon as I can. I have an appointment on March 5th for the dentist to fill some cavities on my lower teeth and he said at that appointment that he will let me know what he has arranged with the oral surgeon who will be removing my remaining teeth on top. I am interested in what you think about the fact that whenever I brush my teeth my gums bleed. The dentist does not seem concerned. He said to just use mouth wash after I brush. I thought that it was a definite "red flag", to have bleeding gums. The only time they bleed is when I brush my teeth. I am using the softest tooth brush I can find and I am trying to be very gentle but my mouth fills with blood. It stops after I rinse my mouth a few times. I do worry about this Thrush issue and having bleeding gums. I read that it is not good to get thrush in your system. I look forward to your response !
bless you
Holly

REPLY
@hlp123

Dear Lori,
Thank you so much for your response !!! I am so grateful that I have your wisdom to guide me. I have some good Greek Yogurt so after I read your message last night I followed your advice. I usually eat blueberries and yogurt every day because it is suppose to reduce inflammation. I will get some organic pure coconut oil as soon as I can. I have an appointment on March 5th for the dentist to fill some cavities on my lower teeth and he said at that appointment that he will let me know what he has arranged with the oral surgeon who will be removing my remaining teeth on top. I am interested in what you think about the fact that whenever I brush my teeth my gums bleed. The dentist does not seem concerned. He said to just use mouth wash after I brush. I thought that it was a definite "red flag", to have bleeding gums. The only time they bleed is when I brush my teeth. I am using the softest tooth brush I can find and I am trying to be very gentle but my mouth fills with blood. It stops after I rinse my mouth a few times. I do worry about this Thrush issue and having bleeding gums. I read that it is not good to get thrush in your system. I look forward to your response !
bless you
Holly

Jump to this post

Hi Holly. I can’t see your mouth to know why your gums are bleeding but thrush may be to blame, since you have an ongoing case.
Bleeding gums can also be a sign of periodontal disease, which can lead bone loss and ultimately tooth loss.
I’m wondering if you have bone loss around the teeth that need removing. If that’s the case, then there can be little gaps or periodontal pockets around these teeth. No matter how careful or meticulous you are at brushing, food and bacteria can still collect in those areas. That can cause inflammation and gum bleeding.
Are you also having bleeding around the lower teeth that will be saved? I think you mentioned recently having a cleaning. Did the hygienist mention anything about gingivitis or periodontal disease? Can you determine exactly the area that bleeds the most?

I thought of one more thing to help you beat this bout of thrush besides the coconut oil and plain yogurt.
Try brushing your tongue gently, several times per day. Start in the back and move forward, brushing and making circles on your tongue with the brush. You can use toothpaste if you wish. The goal is to break up the yeast colonies on your tongue, cheeks or roof of mouth to keep them from multiplying.
The coconut oil helps to keep them from forming as well, but the more you can destroy the easier it is to get this under control. Not sure if it helps or not, but every night after my last brushing, I pour 97% rubbing alcohol over my toothbrush to disinfect it.

You’re a kindred spirit with the plain yogurt and blueberries! That’s how I eat it too! It’s also important to avoid extra sugars and starchy foods. Yeast loves sugar so anything you can do to avoid that will also help you.

Here’s a little article on the benefits of the coconut oil!
https://www.healthline.com/nutrition/oil-pulling-coconut-oil
Let me know if you see any improvement!

REPLY
@loribmt

Hi Holly. I can’t see your mouth to know why your gums are bleeding but thrush may be to blame, since you have an ongoing case.
Bleeding gums can also be a sign of periodontal disease, which can lead bone loss and ultimately tooth loss.
I’m wondering if you have bone loss around the teeth that need removing. If that’s the case, then there can be little gaps or periodontal pockets around these teeth. No matter how careful or meticulous you are at brushing, food and bacteria can still collect in those areas. That can cause inflammation and gum bleeding.
Are you also having bleeding around the lower teeth that will be saved? I think you mentioned recently having a cleaning. Did the hygienist mention anything about gingivitis or periodontal disease? Can you determine exactly the area that bleeds the most?

I thought of one more thing to help you beat this bout of thrush besides the coconut oil and plain yogurt.
Try brushing your tongue gently, several times per day. Start in the back and move forward, brushing and making circles on your tongue with the brush. You can use toothpaste if you wish. The goal is to break up the yeast colonies on your tongue, cheeks or roof of mouth to keep them from multiplying.
The coconut oil helps to keep them from forming as well, but the more you can destroy the easier it is to get this under control. Not sure if it helps or not, but every night after my last brushing, I pour 97% rubbing alcohol over my toothbrush to disinfect it.

You’re a kindred spirit with the plain yogurt and blueberries! That’s how I eat it too! It’s also important to avoid extra sugars and starchy foods. Yeast loves sugar so anything you can do to avoid that will also help you.

Here’s a little article on the benefits of the coconut oil!
https://www.healthline.com/nutrition/oil-pulling-coconut-oil
Let me know if you see any improvement!

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Is there a group for lapan laser? I'm scheduled for one in April and would love to hear from people who has had it done. Thanks

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@cat714

Is there a group for lapan laser? I'm scheduled for one in April and would love to hear from people who has had it done. Thanks

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Good morning, @cat714. Looking through discussions in the forum this morning, I wasn’t able to find mention of the patients having LANAP Laser treatments. However, from my experience in seeing this in action, it is a much less invasive and virtually painless way to treat gum tissue disease than with conventional gum surgery.

I found a good article that you might be interested in reading that explains the procedure.

https://www.dentaly.org/us/gingivitis-treatment-symptoms/laser-gum-surgery/

Are you having this done to treat periodontal disease or for gum contouring?

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