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Alendronic acid and teeth

Posted , 18 users are following.

Green_Granny
Green_Granny

I've mentioned my toothache before but can't remember under what heading.

My dentist referred me on to an oral surgeon because I need an extraction (she also put me on 2 anti- biotics). Have just seen oral surgeon who said that normally they would do such an extraction within the practise, but because of my medication history she would refer me to the hospital :cry: :cry:

I have been off alendronic acid for 10 weeks now but apparently it goes on effecting dental work for 2 years. I know somewhere I read that doctors should advise their patients, before putting them on AA to have any dental treatment. Mine certainly didn't! :shock:

I gathered that you run a risk of what the oral woman called \"bone crunching\", and some of the jawbone actually dying. She seemed to think that a lot of this was new thinking. So perhaps I should excuse my doctor.

Anyway the anti-biotics have cleared up the pain - but not without yet more side effects! Won't go into those details sad

Have any of the rest of you had similar problems? Green Granny

1 like, 58 replies

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  • beev
    beev

    Posted

    Hi Green Granny,

    Sorry to hear about your teeth problems. How long were you on the AA? I wonder if they can tell from a scan what state your jaws are in and whether the AA has affected your jawbone??

    I think they are learning more all the time about AA. it does seem to me they should think at least twice before putting people on them - I certainly didnt have the possible downsides explained to me or advice to have dental work done first.

    You might have seen my posts on here but I will repeat - I had some jaw discomfort for a few months before Xmas (when I opened my mouth wide eg to yawn) - my GP took no notice at first then, the second time I mentioned it a few weeks later, suddenly reacted and rang a specialist at the hospital and then made an urgent referral to the hospital (general surgery dep) for an xray and then appointment.

    In the meantime he told me to stop the AA immediately. They saw me very quickly. No problem showed on xray but apparently it wouldnt anyway. The specialist said he would have sent me for scan but didnt because it appeared to be abating.

    He said he was pretty sure it was to do with the AA and that I should NEVER take any medication in the Bisphosphonate family again and to avoid any dental surgery for as long as I could.

    I am taking extra Vit D3 (available in health shops) - -1000 units a day on top of the Adcal which contains some Vit D3. This helps the calcium get into your bones I believe.

    Well, I hope your teeth improve without surgery in the meantime and that you have no more of those nasty side-effects!!

    Beev

  • mrs_k
    mrs_k

    Posted

    Many moons ago (Feb 2007) I was offered AA and read the side effects and said, politely no way. Offered other Bisphosphonates and said ' let's wait.

    Still waiting and still not taking them, but that is a personal decision.

    But over the years, on and off I have read of people having trouble, in particular with AA.

    I just wish everybody would read the side effects and then ask the question, is this drug really necessary.

    We must learn to question.

    • jill24002
      jill24002 mrs_k

      Posted

      When I was first prescribed Fosamax around 1998 there were no known side effects, and I continued to take this medication (which my GP said I would be on for life) until 2011 when I had a dental problem and was told that the cause of this was alendronic acid which had caused my jawbone to die.   At that point my GP said I should come off the drug immediately, having been on it for some 12 or 13 years.   At no point during that period, that I was aware of, had a drug review ever been carried out.   I initially lost a couple of teeth and a piece of my jawbone was removed for a biopsy.  I tried to get some compensation from my GP's practice, which I felt would help towards the cost of replacing the gaps I now had, but to no avail.   I then submitted a claim to the Ombudsman, but it was ruled that as my GP had no knowledge of this possible side effect when the drug was[u] first prescribed[/u], they had no liability towards me.   Over subsequent years I have lost further teeth, although no one will actually confirm that this is because of my previous use of bisphosphonates, but this is what I suspect.   Nowhere could I find a date when this problem was first identified, but just recently I read a newspaper article which stated that this problem was first identified in 2003 - 8 years [u]before[/u] I was told to discontinue the drug when I first had the problem!

      I have taken legal advice, but have been told that I am now outside the time limit of 3 years from the date of the incident, although only by about 2 months, and in the meantime I have struggled to find anyone who would confirm that all these problems have emanated from my prolonged use of alendronic acid.   I feel very angry that nobody wants to take responsibility, and I have suffered and am continuing to suffer, both dentally and financially, to find a solution to my problem that nobody is prepared to take responsibility for.

    • EileenH
      EileenH jill24002

      Posted

      I googled "FDA warning about Fosamax" and the reading on a site called drugwatch is quite illuminating just as a start.

      What makes me most angry is that the FDA releases warnings which the UK blithely ignores. If you mention it to many doctors they so often look down their noses at the poor little patient who thinks they know aout these things. If the FDA issues a warning at any level you know there has to be something behind it - because Big Pharma (and food manufacturers) have the entire USA in their pockets.

      I was very lucky - I knew enough to insist I wanted a dexascan and could do the homework about alendronic acid and the GP I saw said he was of the same opinion as I was and not to bother taking it.

      The trouble was that the manufacturers did a superb marketing campaign and what doctors learn at a particular period of their lives sits very firmly. You will STILL find rheumies who believe it is better than risking a fractured hip. There are plenty of things to do to avoid the risk of that before risking the really VERY unpleasant effects that may come with AA.

      That said - my cousin is about to lose several teeth due to advanced periodontal disease that none of her (trusted) dentists whom she had visited every 6 months and had the hygienist appointments have mentioned to her at a stage when something could have been done. It is in the hands of medical negligence lawyers.

      I'm so sorry to hear your story - but a hope it will have a happy ending is rather unlikely I suppose. We will continue to fight our corner.

  • MrsO-UK_Surrey
    MrsO-UK_Surrey

    Posted

    I'm with Mrs K on this and haven't taken any of the bisphosphonates..... just relied on live yoghurt.
  • MrsO-UK_Surrey
    MrsO-UK_Surrey

    Posted

    Dear [color=green:d636cc25e3]Green Granny[/color:d636cc25e3]

    As for \"any of the rest of us having similar problems\", my tooth enamel is fracturing all over the place and I'm having multiple crowns and spending a fortune! :roll: But, in my case, I have never taken any of the AA drugs and my problem is apparently caused by the steroids. To aggravate things, my appointment with new dentist was cancelled at the eleventh hour last week and have to wait another month as that's the earliest she can fit in a half hour session!

    I'm so glad for you that at least the antibiotics have relieved your pain as there's not much worse than raging toothache. If you have the tooth out using local anaesthetic, the good news is you shouldn't have to increase the steroid dose - that is normally reserved for general anaesthetics whilst on steroids.

    Hope you're enjoying the sunshine today!

    MrsO

  • Margherita
    Margherita

    Posted

    I am taking Calcichew-D3Forte - 2 tabs a day- and once a week, I am taking Risedronate Sodium 35mg film-coated tabs. Any opinions on these ? I feel giddy, and still have a feeling of pins and needles from my left shoulder . Awaiting kind comments. Love. Granny Moss.
  • EileenH
    EileenH

    Posted

    Granny Moss - how long have you been taking risondrenate sodium and did you have a DEXA bone scan at the beginning to see if you had any osteoporosis?

    The calcichew is absolutely standard and needed with the risondrenate to make sure you have enough calcium to be bound to the bone.

    EileenH

  • Green_Granny
    Green_Granny

    Posted

    Dear Mrs O.

    So sorry to hear of your continuing problems - and hope it's not whatever it was called. You are always so positive and helpful to the rest of us

    One sometimes feels that it goes on and on, and one thing leads to another, and one medication then leads on to another etc. etc :?

    Someone, Mrs G? asked how long I had been takong AA. About 23 months - and, of course, then I was just pleased as it sounded a GOOD THING! I did ask Dr about 6 months ago whether there was any alternative and he just said \"No\" Which is why I stopped it myself before Christmas, thinking I am now on a low enough pred dose not to be suffering much from side effects.

    Welcome back Eileen -we missed you!

    Green granny

  • fiftiesgirl
    fiftiesgirl

    Posted

    Mrs O I am so sorry to hear of your ongoing problems....... having read all the posts have been shocked.... was totally unaware that by taking Alendronic acid on a weekly basis it would have a detrimental effect upon my 'bone' health! Thought it was supposed to protect me from the effect of the steroids?

    Seeing doc next week so will certainly raise it with her although it was the rheumy who prescribed it..... would I be 'safer' discontinuing it?

  • EileenH
    EileenH

    Posted

    50sgirl: steroids affect the way in which your bones take up calcium into their framework which is the reason that the density of your bones may fall whilst on them. Alendronic acid is also taken up into the bones and then attracts the calcium and is supposed to maintain the bone density and prevent osteoporosis. I have posted at length about alendronic acid in the past and I won't repeat that here (I'll look up the threads later and tell you which ones or you can search for it yourself using the box at the top of the page).

    It is quite a controversial drug with some serious side-effects which were claimed originally by the company that developed it to be rare - on the basis of the clinical trials which obviously only have limited numbers of people over a relatively short period of time. The true degree of side-effects only ever becomes apparent once the drug is being used for large numbers of proper patients over a long period of time and it is now being found that this wonder-drug that was to save us all from broken hips when we are ninety has more downsides than at first thought. One particular type of fracture of the thigh bone is found almost exclusively in patients who have been taking biphosphonates (as these drugs are called) for some time. The American FDA has now recommended that they are only to be used for a maximum of 5 years at a time and checks should be made for this type of fracture and demands are being made for more studies to be carried out on the long term effects of taking them.

    Personally, I think they shouldn't be used \"just in case\" - which is what the drug company has managed to convince many doctors to do on the concept of \"prevention is better than cure\". Makes lots of money for the company - am I being cynical?? :roll: I am firmly of the opinion that a Dexa bone density scan should be done about 3 to 6 months into your steroid treatment and then at intervals thereafter and only if there is any sign of osteoporosis should treatment with the alendronic acid be started - i.e. IF IT IS NEEDED. Only about 50% of patients develop osteoporosis - why take the stuff unnecessarily? It is unpleasant to take and has side-effects - some worse than the fracture it is supposed to prevent. And some experts are of the opinion that it doesn't actually really prevent those broken hips anyway.

    The steroid-related bone density loss is mainly at high doses and in the first few months of treatment. If you get past that period with no sign of serious deficit appearing then there is probably little likelihood of it happening. I don't have any such signs, I don't take AA (did take it for about 8 weeks) and will do all I can to avoid doing so. It would be helpful if doctors knew enough about using the stuff to tell you to go and get a thorough overhaul of your teeth before starting on a protracted steroid course - that's because the steroids put you at risk of infections if anyone starts poking around at your gums. And, in addition, one of the really nasty things with AA is that it can cause necrosis (death) of jaw bone tissue and I presume they think this is more likely if you need extractions/major dentistry work and then the bone doesn't heal properly.

    We said before it is a personal choice - mine is not to take it. I would consider it if they showed me I was developing osteoporosis but even then I might not take it. There are other ways of preventing the problem. I would certainly discuss it at length with your GP and want some sensible info. They do not yet know what happens when you take it for years and years as was the original idea - they are beginning to find out. And it remains in your body for a very long time - you can't just wash itout. Like other wonder drugs before it it may well turn out to have feet of clay.

    EileenH

  • eleanorlane
    eleanorlane

    Posted

    Hi Green Granny

    and all who use alendronic acid and have used it, or have been thinking about using it.

    My bad experience with it happened qwite quickly after having it prescribed by my Dr. He first prescribed one form of it in Fosamax (a very well known drug here in the US) and after a monthe of weekly doses I suddenly developed extremely sharp insistent pain iin my right shin bone. It was so painful I immediately stopped taking it and informed my Dr. The pain stopped and a month later he prescribed another brand of the AA. It wasn't quite a month that the same pain started in the same place. After the same occurance my Dr. gave up on trying me on that drug and told just to be sure to take my calcium plus all the other bone building foods and Vits. I should tell you too that for many months had a mild jaw pain. I had had TMJ quite awile ago, so this jaw pain didn't seem so bad.

    Just cautioning all of you, before using AA please Google it and find out all you can about it.

    I'm sort of stuck on taking 3 Mg of pred right now. Have been trying 21/2 for a few days and got some of that old pains and siffness back and a general feeling of weakness and not feeling \"up to snuff\" so relented and went back to 3 for 4 days and today went back to try 2 1/2 again. This is the first hiccup I've had in reducing, so have been very lucky.

    Been almost 21 months now on this journey. I really can't complain when I read some of the journeys a lot of you have been on.

    Better health to all of us. And thanks to all you who encourage us with your help and humor.

    Tinker

  • EileenH
    EileenH

    Posted

    And to illustrate the lack of knowledge on the part of some doctors - Tinker's doc was incorrect in his assertion there is nothing else! There are other drugs that build bone that don't have the same effects as Fosomax and its siblings. One is a strontium complex. But they cost more. They can be prescribed if necessary for patients who can't take the alendronic acid and are at serious risk from osteoporosis but approval is required from your health authority.

    Good to hear from you Tinker - how's the golf?

    EileenH

  • Mrs_G
    Mrs_G

    Posted

    Hello green Granny

    so sorry to hear about your dental problems as we have discussed on here over the last week I have just given up AA as didnt like taking it and now on a low dose of steroids I really did tend to ignore the side effects of this drug as it was only once a week

    I think if I had read about it I might not and I do think to say have your dental work first is a bit silly because no one ever knows when their teeth are going to cause problems !!

    Lots of talk on American websites about court cases re AA and still ongoing

    The hygenist I saw did mention some bone loss in my jaw ( new Dentist so Xrays done ) but was talking about not cleaning between teeth properly can cause infectiion and bone loss she asked about the steroids but nothing else So I shall have a chat with them both next time I go

    Im glad Im not taking it now My sister in law has been taking Fosamax ( I think its the same ) since 2002 She was on high dose steroids and is on 6mg permanantly and methatrixate has osteoporosis and actually has a fracture in her leg she didnt even know about it !! it does make me wonder if she should have been on this drug for so long

    Hope you get something sorted about your teeth shortly

    Mrs G

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