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Oral Surgery/Extraction of two molars after Reclast infusion

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Question
Dr. Joel S. Teig, I have two molars in upper left quadrant that became abscessed supposedly after I had a Reclast infusion on Feb. 12,2015. I went to my dentist and he said they were abscessed badly and so he sent me to my oral surgeon for a digital x-ray and the oral surgeon said they were bad but he would not extract them because of the Reclast infusion. he said, even if my dentist had to grind them down to the gum, to have my dentist do root canals on them. Note: both teeth have crowns. So I went back to my dentist who first said I should see an endodontist. I was not able to find an endodontist anywhere in my area who did root canals using conscious sedation, of which my endocrinologist said should be used to prevent trauma. So back to my dentist who said it looked like he would have to do the root canals using injection for numbness. He started on the worst tooth first,second form rear in upper left quadrant. The other tooth is the third from rear in same section. He said it might take two appointments, but after the third appointment he said this tooth is so bad that i think what I should do is not put the root fillers in this, which he said had three branches to ream nerves from, but I will pack it with cotton and put on the outside seal (mixture that is soft then hardens) and will be easier to drain if needed. Then it is scheduled for the other tooth for a root canal last week in June. Dr. Teig, I am at a loss as to what I should do. I feel the two teeth should be extracted but have no idea as who to see to have this done. Could you possibly offer me your impression as to what I should do and maybe who I should see if extractions are in order?          

Thank you,
Ronnie

Answer
Ronnie - The main problem is the Reclast.  Most dentists will only extract teeth on patients taking Reclast if the patient is fully aware that the extraction of the tooth may precipitate a severe degeneration of the bone surrounding the teeth to be extracted.  This is why knowledgeable dentist attempt to not extract or do oral surgery on the patient.  

I don't know where in Virginia you live, but there is a dental school in Richmond.  The endodontist there who teaches should be highly skilled in endodontics and should be able to perform the the root canals successfully and prevent the need for extractions.  So contact VCU Dental school and ask to be evaluated by the doctor who heads the endodontic department.  I  also suggest that the oral surgeon you have seen speak with the doctor at VCU.  If you have any problems or questions, feel free to contact me again.

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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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