Re: bisphosphonates and dental extractions
I would like to learn from those of you on bisphosphonate or having been on bisphosphonates about how you dealt with more invasive dental procedures. I am curious to learn what precautions your dentists took; did you have antibiotics before and after. Did you have a closure of the wound, so no bacteria would get in? Did any of you forgo extractions? Did any of you have implants?
I am quite confused by the different opinions I have gotten over the years from various dentist or physicians. I have taken Alendronate from 2011-2018, in 2014 had one infusion of Reclast. I had a drug vacation since 2018. But now, in 2023, I have to go on drugs again. I need a tooth extracted before (my teeth de-mineralize). In 2018 I consulted with maxillofacial surgeon at major university re an extraction. He completely advised against it, and he told me to get a root canal and cut tooth at gum line. I did so after he described in vivid detail the cases of osteonecrosis he sees in his clinic after tooth extraction in persons with IV Bisphosphonates. My bone physician felt the danger was not as great as this physician saw it. I needed another extraction in 2021. I saw a different maxillofacial surgeon then. He did not want to extract the tooth. A great endodontist preserved the tooth with a root canal against all odds in the end. The tooth is fragile and ugly. Finally in 2022 I had to have an infected tooth extracted. No antibiotics taken after, no primary wound closure done, but had bone graft. I was really worried about the easy-going approach, about not taking antibiotics. Suddenly the whole extraction in people like me was no big deal ? I did not get it. The American Dental Association recommends following precautionary procedures in persons having taken bisphosphonates. Maybe this is only valid for a certain time? I do not know what to think anymore but I have to face another tooth extraction now.