Dentists teeth bisphosphonates and all that

OK this is a sensible thread, having seen a couple of people posting on the gormless thread about teeth.

I need to have some work done on my teeth and was a bit wary when my dentist wouldn’t do anything because I am on xeloda and bisphosphonates. With the xeloda she is worried about my resistance to infection. With the xeloda she is worried about osteonecrosis of the jaw.

I took myself up to the Marsden to see what they had to say and the dentist there (a lovely lady who gave me as much time as I needed to talk) said that on no account would she want to remove a tooth in someone who had been on bisphosphonates for two years, like me. She said that even if I had an abscess she would treat it for as long as she could with anitbiotics before taking it out. The reason for this is that there is a risk (small but significant) that the socket in the jaw where the tooth comes out won’t heal properly - this bisphosphonates stop it happening - and you end up with a hole in your mouth that can become smelly, infected and so on. Where she HAS taken teeth out, it has taken two years for the jaw to heal.

She also told me that there is no point in taking a break from bisphosphonates to allow time for dentistry. She said that bisphosphonates stay in the body for ten years and that the risk will therefore be the same whether I am on a bisphosphonate break or not.

Interestingly, she also told me that there was a slightly greater risk of developing osteonecrosis of the jaw if I switch from one bisphosphonate to another. She doesn’t know why, and can’t quantify the risk, but it is something that she has observed. It makes me very wary of the bisphosphonate swith I was planning.

On the up side… she said that fillings, root canals etc are perfectly safe, but recommended that I go to a good and experienced private dentist for my root canal that needs doing. Apparently NHS dentists will do the cheapest job possibe on a root canal, and this may not be the best job. It seems with root canals for people on bisphosphonates only the best is good enough!

So… with that in mind… does anybody know a shit hot dentist in the Surrey or South West London area who they might recommend. I too fell out with my previous dentist before transferring to the NHS practice that I am now with - one that appears to be staffed only by young girls on gap years with no experience whatsoever!

Any recommendations gratefully received!

Deirdre

Moderators - please can you investigate why this post has not appeared in the living with secondary breast cancer forum? This is the second time this has happened to me and it is very frustrating!!!

Hi Deirdre

I will pass this on to be looked into. In the mean time I will try to move this post for you.

Best wishes
Sam (BCC Facilitator)

I have pm’d you Deirdre

Deirdre - just to confirm, I had my tooth extraction after only five Pamidronate infusions - the hospital dentist told me there wasn’t too much risk as I’d only just started it and confirmed what you say, that if you’ve been on it a couple of years or so, the risks are much greater.

Good luck with it all!

Lesley xx

have sent you a PM

Hi Deirdre

Really sorry to hear of your dental troubles. Though I posted on the gormless thread about mine it is actually something which I am really worried about because I have advanced gum disease and my crowns and bridge are very precarious.

I have a dentist I like who says he will find a solution when/if the bridge or crowns become unuseable. I like him but probbaly not shit hot enough for you to come this far.

Hope you get a good recommendation.

Jane