Tooth extraction while on Zometa

I have been on IV Zometa for nearly two years and need to have a tooth removed but am worried about osteonecrosis - is there anybody who has a tooth removed without any problems. Would be grateful to hear other experiences. Thank you

Hi darcie,
Haven’t had a tooth removed but have been ob Zometa for 18 months now & know you MUST tell your dentist you are on bisphosphonates, if you haven’t already done this.
Good luck!

I had a tooth removed just at the end of chemo.I was also taking bondronat.My dentist would not take out the tooth because of the bondronat and the fact i was having chemo.He referred to maxiofacial at the hospital.My onc however wanted me to wait until the end of chemo.
I had no problems with the exstaction.had to have a blood test and they put soluble stitches into the gum to prevent bleeding.It healed up fine and i had no problems at all.I was however pleased I had it done at the hospital.They were very proffessional and I felt happier having it done there.

Hi darcie,

I had a bad tooth infection and they did everything to save the tooth. So, luckily, I avoided it! I was told you have to stop having IV Zometa for 4 weeks (or something like that) before having a tooth extraction, then go back on it after it’s healed.

Speak to your dentist and oncologist, they will have a better idea.

Hope it goes well.

Hi Darcie

Poor you! dental treatment is stressful enough without having to worry about necrosis etc.

My dentist has been very concerned about me being on Zometa and I have to have 3 monthly appts, strong flouride toothpaste and lot of lectures about good oral hygiene. Is there any way that the tooth can be saved? I think we are at a risk of necrosis, but it doesn’t necessarily mean it WILL happen! I think being referred to a specialist dental hospital, as happened to Lucinda would possibly be a good idea.

Good Luck with it all xx

Hi Darcie
Like Lucinda I had a tooth out whilst on Bondronat and was referred to the maxiofacial unit at my hospital. No complications but it is worth asking your onc what would be best. The dental surgeon who removed my (untreatable) tooth was also the person at the hospital responsible for reporting any incidences of osteonecrosis and said he had never seen a case. However he ominously said it was a ‘time bomb waiting to explode’ as I think there are so many people on them now for osteoporosis as well as bone mets.
Good Luck
Nicky x

Likewise my Onc referred me to the hospitals mixiofacial unit and advised against going to own dentist. They gave me extra antibiotics to try to make sure all was ok - but I was on Zometa and post-chemo so think the antibiotics were to due to the chemo and low immunity.

I have been taking oral Bondronat for 9 months had no dental extractions and had a dental check up in January before treatment commenced. However, I have now been diagnosed with osteonecrosis of the jaw and am seeing the maxillary facial team. So just to warn any ladies that it can occur without having any dental treatment but apparently is very rare. At the moment I am being treated conservatively in the hope that it will heal but this does not seem to be happening. Have a further appointment in two weeks and maybe some treatment will be started. I have liver mets with two micro metastases in the spine T1 and T3 and am currently having chemo docetaxol after having FEC last year and further progression in the liver am on cycle 4 of 6. I wonder if any of you ladies know of any association between osteonecrosis and osteo arthritis and if chemo and steroids increase the risk of occurrence. My scan results were positive and I am working full time through my chemo even with the osteonecrosis and the normal side effects from Docetaxol. My best wishes to all the ladies on this site stay positive and enjoy life. Take care. X

Poor you agraham :frowning: I hadn’t come across anyone on these boards at least, that had had it. I hope it is treatable for you but I understand it’s quite painful. Rather worrying that it can happen with no tooth extraction as well. I really can’t help about whether there’s a link between the circumstances you mention but maybe someone else will come along and help. Good Luck with the chemo and you stay positive and enjoy life as well :slight_smile:

Hi Ladies,

My mum is struggling with her teeth at the moment, she has her treatment tomorrow so will tell her consultant then but reading the posts it doesn’t sound like its a side effect from Chemo it’s from the Zometa. Mum has this in IV before her treatment every three weeks, but she has been saying her teeth are extremely sensitive and feel like they are disintergating into her gums.

Certain drinks and foods don’t help, just wondered if you ladies had any advice on helpful foods or drinks or any general advice?

Thanks and Love to all Jenna x x x

i’m on a monthly ibandronic acid tablet,
and i had two wisdom teeth removed on friday.

my dentist referred me to the hospital
who took them out under a general.

the top tooth came out easy i was told however the bottom
tooth wanted to stay, so i’ve got a stitch in there.

so far all’s going well, i’m on a 10 day course of penicillin
and i’m taking painkillers.

i’m pleased i had them removed at the hospital incase anything went wrong

Hi Lucinda
I’m really sorry to bother you but I’ve been searching the net for any information on having a tooth extraction whilst on bone hardner (I’m on Zometa)
Ive got breast cancer with bone mets. I have a infected molar that needs to be extracted but everyone I talk to does not have an idea of the correct procedure to do this as there is a risk of getting ONJ.
I went on this forum and saw you had a similar thing happen. Do you have any extra info on how you went about getting it done ? Which hospital, dentist etc

Would be really grateful for any help or ideas
Tiddley x

Hi Tiddley

Just wanted to mention our Helpline who can offer support and information on issues such as these. They are open Weekdays 9-5 and Saturday 10-2 and are on 0808 800 6000.

It might also be worth having a conversation with your medical team who will be able to advise.

Best wishes.

Louise, facilitator

Hello Darcie, I have had a tooth extracted while on Zometa.
Firstly you must get your Onclogist and your dentist to have a chat about it. It is not to be taken lightly and my Oncologist made me stop my chemo and and Zometa for a few weeks too before she would agreed to the extraction.
I would NOT recommend that you have it done at your dentist like I had done. I would ask to be referred to the Dental Hospital and I know a few ladies on here have had it done that way. I had cracked the tooth right to the root. It could not be saved and I had a crown done.The tooth kept breaking and the dentist took on more than he could chew! Excuse my wicked sense of homour!
I then broke another tooth a couple of years later but this one could be saved and my Oncologist again spoke with my Dentist and I had a repair done on that one. Both have been fine but make sure your dentist knows about the probelms that these drugs can cause because my dentist did not and he told me he had elderly patients who had these drugs but not bone cancer and they did not know the probelms that it coud cause. Luckily I spoke to my Oncologist first and she knew!
I saying all that I have NOT had any problems and I have been on Bophosphonates for over 12 years now! There was a thread on this before as a few of us had posted on it but I think it is in the Archives section now. But I think I have given you enought to get your teeth into for now ( sorry ) Love Val

Hello Val

Thanks for your post which I’ve read with interest. It’s been difficult to get the dentist and onco to talk. But I just
come off the phone from the Dentist again and he is referring me and has recommended a maxiofacial surgeon down in Guildford. Looks like I’m going to have to have it done privately in hospital too as I was told earlier on another information finding call that a referral on NHS can take 6 weeks and then another 4 weeks for it to be done.
Tooth extraction and Zometa is such a grey area with little information out there. Which is surprising as the consequences of it going wrong is very serious.
I will keep everyone posted on this site as I get useful information and a positive and good plan of action to get my infected tooth extracted.

Hi everyone

Is there any one out there that can help with any knowlegde/experience of having a tooth extracted whilst on IV zometa ?
I need to have a molar that keeps getting infected in the gum line (on antibiotics again ) extracted but am facing
very little information from my GP, Dentist and Onco believe or not ! There is a serious risk of ONJ with this extraction.
No one seems to know exactly what I need to do /plan in order to ensure minimum risk of ONJ.
Does any one out there know of a good hospital, doctor , dentist ?
thanks xx

Thanks Louise . Is it a free number ? and from which line is it best to call ?

Hi Tiddley

Yes, it’s a free phone number. 0808 800 6000.

Best wishes.

Louise, Facilitator

Tiddley, Make sure that you contact your hospital Consultant’s secretary before you undergo any threatment. Do not go ahead until you do this as she may want to delay things anyway. I had local anaesthetic but other ladies on here had it done in hospital under a general anaesthetic. PM me anytime if you need any info. Val

Hi Val

Thanks so much for your support. I just came off the phone to my Onco (in Guildford) secretary Christine and I just had a long discussion with her on phone , her reply was ’ He does not deal with teeth you have to see the dentist ’ !
She said she had never had anyone with a similar problem and couldn’t help with any advise etc . She told me contact the registrar (most of one them there have been there 2 minutes and I have already tried to speak to one who didnt know either !)
Losing faith rapidly in all of this. It is such a serious procedure and I can’t believe that I’m just being sent round in circles to try and find the correct proper help.
I’m still waiting for this dentist to come back to me now with the contact details of this maxilla surgeon at the Nutfield.
I have his name do you think I should try and contact him myself ? In the meantime I’ve had to go back to my GP this morning as the infection is getting worse and had to get stronger anti biotics.