Restrictions with Reclast and tooth extraction & dental work

Did this oral surgeon say what your alternative is regarding an extraction?

Yes, this is a side effect of Reclast - and it doesn't take 4 doses of Reclast to have problems. You are fortunate your oral surgeon alerted you to the issue. As far as alternatives to extractions, there aren't any. You just hope your jawbone will heal and not develop necrosis (death of the bone in parts of the jaw).

From what I understand from several dentists and this forum, the issue is not that you can NOT have an extraction, but rather that there are risks involved, specifically the risk of getting osteonecrosis of the jaw. That risk goes up with more years on Reclast -- if I remember correctly 3 years on Reclast, 5 on alendronate and similar oral forms of a bisphosphonate. But again, that doesn't mean that you can't have an extraction. There are various ways oral surgeons work to minimize the risk -- like by having you on antibiotics both before and after the extraction.

Thank you for all the replies. I have a very hard time tolerating antibiotics because of my other health issues. Once I resolve this tooth problem, I will need to restart osteoporosis treatment — the question is which medication to choose.
According to my endocrinologist, what my oral surgeon said is objectively not accurate. Any osteoporosis medication I choose will eventually require transitioning to Reclast for maintenance. My endocrinologist also emphasized that my dentist is not fully informed about how Reclast works. Dental work is considered safe once at least one year has passed since a Reclast infusion.
If I choose Forteo or Tymlos — both of which are safe for dental procedures once the course is completed — I will still need to go on Reclast afterward for 1–2 years.
I still have my molars, and I am extremely worried. I truly hate the idea of osteoporosis medications because all of them come with such frightening warnings.
My oral surgeon said he would not perform an extraction if I had four lifetime doses of Reclast. Since I won’t have the option to avoid Reclast in the long run, I will likely need to find another oral surgeon.
@sebutler, you’re right — I was fortunate that he at least warned me. Another office simply asked for a note from my PCP stating that I’m “healthy,” but that makes me question whether I really want to go to a doctor who doesn’t consider all the risks involved.
Or maybe I’m looking at this from the wrong angle. Maybe the issue isn’t the oral surgeon — maybe I need to reconsider my endocrinologist. Most endocrinologists follow a standard protocol that’s meant to fit everyone, and it’s incredibly difficult to find someone who is truly experienced and nuanced in osteoporosis care.
I keep wondering whether it’s even possible to avoid Reclast, or if everyone is essentially “forced” into it for maintenance. If Reclast is unavoidable, then my current oral surgeon’s restrictions mean I’ll eventually need to find someone else anyway. But at the same time, I don’t want to rely on a doctor who ignores the risks altogether.