Have had 2 Reclast infusions and may need a tooth extraction.

Posted by janetws @janetws, Jun 7 9:48am

I have pain in my face with some swelling, pain in the gum above tooth 13 which has a root canal, muscle cramping in my left neck. Have had MRI to rule out ‘trigeminal’ neuralgia. I have had 2 reclast infusions and am scheduled for my 3rd August 23, 2024. The endodentist has done a CT scan twice and said the root canal is fine but if the tooth is cracked it may be leaking then it should come out but he can’t tell if it is cracked. I have more pain when I lay down at night than during the day. Not sure what to do?

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

Have you seen a neurologist? (Interesting that you had an MRI to rule out trigemninal neuralgia..I didn't know it could be detected on imaging). Maybe a lidoacaine injection for trigeminal and occipital neuralgia would help clarify things. Did the endodentist use cold and shock to test the root?

Did your endocrinologist say you could delay Reclast to investigate this situation?

REPLY

Janetws, osteonecrosis of the jaw is one of the adverse effects of bisphosphonates like Reclast. The incidence is very low, but you shouldn't have the tooth removed while on Reclast. Maybe switch to Forteo in August.

"Bisphosphonates inhibit bone resorption by causing osteoclast cell apoptosis, impairing the osteoclast’s resorptive capacity, and preventing osteoclast formation.[5] They have a high affinity for bone minerals and accumulate mainly in the sites of osteoclast activity.[5] Without resorption and new bone formation, old bone survives beyond its lifespan, and its capillary network is not maintained, leading to avascular necrosis of the jaw. "
https://www.imrpress.com/journal/FBE/3/1/10.2741/E251

REPLY
@windyshores

Have you seen a neurologist? (Interesting that you had an MRI to rule out trigemninal neuralgia..I didn't know it could be detected on imaging). Maybe a lidoacaine injection for trigeminal and occipital neuralgia would help clarify things. Did the endodentist use cold and shock to test the root?

Did your endocrinologist say you could delay Reclast to investigate this situation?

Jump to this post

Yes I went to a neurologist and had 3 lidocaine injections. The first 2 seemed to help but the 3rd only lasted a few days. The neurologist referred me to a neurosurgeon who ordered the MRI for original neuralgia. He said there was no vascular compression so no need for surgery. No he did not use cold and shock to test the root.
I have not contacted my endocrinologist at Mayo, Rochester yet, I just got the MRI results yesterday. Thank you so much for responding to me!!!

REPLY
@gently

Janetws, osteonecrosis of the jaw is one of the adverse effects of bisphosphonates like Reclast. The incidence is very low, but you shouldn't have the tooth removed while on Reclast. Maybe switch to Forteo in August.

"Bisphosphonates inhibit bone resorption by causing osteoclast cell apoptosis, impairing the osteoclast’s resorptive capacity, and preventing osteoclast formation.[5] They have a high affinity for bone minerals and accumulate mainly in the sites of osteoclast activity.[5] Without resorption and new bone formation, old bone survives beyond its lifespan, and its capillary network is not maintained, leading to avascular necrosis of the jaw. "
https://www.imrpress.com/journal/FBE/3/1/10.2741/E251

Jump to this post

Thank you for replying to my post!!! I will not have the tooth removed now and will make an appointment with my endocrinologist at Mayo in Rochester. I have a ‘dexa’ scan scheduled for August 8.

REPLY

Five years ago I had something similar. Dentist x-rayed and found infection. Neither he nor endodontist who'd done the root canal for that tooth could see the cause and guessed cracked tooth. Then endodontist referred me to a periodontist who did a gum flap so he could see under the gum to the roots of the tooth. He discovered that one of my roots (a molar with three roots) was cracked. He then performed a root amputation where he removed the cracked root, filled the gap left with a collagen insert, and sewed the gum back together. It occasionally aches, but that could be caused by my frequent sinus infections.

REPLY
@dlmdinia

Five years ago I had something similar. Dentist x-rayed and found infection. Neither he nor endodontist who'd done the root canal for that tooth could see the cause and guessed cracked tooth. Then endodontist referred me to a periodontist who did a gum flap so he could see under the gum to the roots of the tooth. He discovered that one of my roots (a molar with three roots) was cracked. He then performed a root amputation where he removed the cracked root, filled the gap left with a collagen insert, and sewed the gum back together. It occasionally aches, but that could be caused by my frequent sinus infections.

Jump to this post

Thank you for letting me know. I will share your experience if I have to go back to the endodentist.

REPLY
Please sign in or register to post a reply.