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Oral Surgery/Reclast or Boniva ?

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Question
Hello Dr. Tieg,

I'm a 66 yr old female with many dental issues without dental insurance.  Several of my back molars both upper and lower had to be removed. I was fortunate enough to receive some help through a volunteer dental service in the Tampa bay area in the last few yrs.  They removed the teeth that were in need of removal due to decay.  I have since move back to Michigan my home state and unable to get any help other than a cleaning at the health department which is wonderful. I have both Medicare and Medicaid since I became disabled due to my Lupus.

Ok that was a lot of blah blah information out of the way, now my question.  My new rheumatologist has looked at my recent DEXA scan and I do have osteoporosis in my hips and spine.  Unfortunately after a lupus flare and a few months of prednisone on and off over the yrs.  I wound up with osteoporosis.  My rheumy wants me to have reclast infusions, I'm concerned after researching and reviewing the jaw issue with reclast and that many dentist won't do any work on my teeth.  My hope is to get dentures or a bridge or partial.  Would a dentist be resistant to do this kind of work  with the reclast issue?  Would I be any better off with Boniva concerning dental work?

Thank you reviewing my question.

Answer
Barbara - I would love to be the bearer of good news to your situation.  Unfortunately, all of the medications now prescribed or given to treat osteoporosis can potentially establish a situation where dental treatments (usually surgical treatments) can precipitate significant degenerative situations of the jaw.  So if you need medication to fight osteoporotic changes, I would suggest that you have any surgical dental treatments, like extractions, done before the medications are started.  If you have already started the medications, you can still have the treatments.  Not everyone who takes these medications have the degenerative jaw problems developing, in fact, it is a small percentage, but it if hits it is bad.

So if you have not started the medications, have your dental treatment done soon.  I wish you well and hope you are abler to get the dental work done now.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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