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How likely is the risk of dental complication after having taken Fosamax?

My dentist refuses to pull a bad tooth out because I've previously taken Fosamax, orally, for my Osteoporosis condition. He tells me that I could potentially face a never ending pain in my jaw and would require to take pain killers forever. I don't have any issues with my jaw currently and no longer take Fosamax but need to know how frequently the described condition occurs and what can be done about it? Are there any treatments and does it mean that I can no longer have any dental work done?
Date: Thu-Feb-4-2016-
Response
0
Fosamax is part of the drug group 'Bisphosphonates'. It is thought that bisphosphonates affect the bone's ability to heal by reducing blood supply to the area. When this is severe, bone in the area may 'die'. This in itself is not painful but if an infection arises it can become extremely painful. As Alex mentioned, the condition is called 'osteonecrosis of the jaw' or ONJ. This can occur both spontaneously or secondary to something like a dental extraction.

An article by the American Dental Association (www.ada.org) in May 2010 states that the prevalence of ONJ is less than 1% in people who are taking oral bisphosphonates for osteoporosis - i.e. the risk is very low. A study in Australia estimated the incidence to be between 0.01% to 0.04%. Risk increases with dental procedures such as extractions, being over the age of 65 years and the use of medications called glucocorticoids. In the Australian study, the risk of developing it following dental extraction increased to 0.34%. 

It's good to see that your dentist has considered what medications you are on now as well as in the past. Our understanding of ONJ is evolving and as new information comes out recommendations change. I would suggest you see your dentist again to discuss all of your options and the risks associated with them so that you can make an informed decision.

For further information:
- 'Patient Information', American Dental Association (2009) @
[d] By: rotatable
Date: Thu-Feb-4-2016
Response
0
The issue that your dentist is probably concerned about is osteonecrosis of the jaw. Despite osteonecrosis being a very serious problem, there is only a low chance of it developing due to you taking fosamax. Note the risk of osteonecrosis is higher if people have other dental issues. No doubt your dentist is showing due diligence by being cautious.

Note that the risk of osteonecrosis beceomes extremely unlikely once taking fosamax has ceased. So unlikely that many health professionals would not even mention it as a risk during a consultation.
[d] By: unnoticeable
Date: Thu-Feb-4-2016
Response
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