Hi daisyem,

To date, there are no conclusive studies stating osteonecrosis of the jawbone is only seen in patients using IV bisphosphonates. There are alot more cases being seen overall than ever before and most of them are not being written about. With that being said, most dentists are recommending that their patients stop taking the oral Bisphosphonate for about 3 months before having any oral surgery. However, there are no studies to indicate whether or not that length of time is adequate because these drugs have a 10 year skeletal life in the body.

Your situation is definitely complicated because you take Bisphosphonates. The infection that has developed in the loose tooth will spread to the jawbone if the tooth is not removed. Any bone infection in someone who takes any form of Bisphosphonate drugs has the likelihood of developing osteonecrosis. Therefore because of the infection, you cannot wait the 3 month period even if you wanted to. SO that tooth has got to come out no matter what.

The other loose teeth need to be evaluated thoroughly to determine why they are loose and a treatment plan needs to be established which may include stopping the Boniva at least long enough to deal with these teeth too.

Bisphosphonates are designed to prevent bone loss. But in doing so, they inhibit the growth of new healthy bone thus inhibiting an injured bone to heal properly. This information should automatically be part of the information given to the patient at the time of the prescription....... without a doubt.

I know you are in a panic and I am so sorry that you were not fully informed of the negatives about taking these drugs prior to having them prescribed to you. Because of the mounting evidence being written about the poor prognosis of bone healing in Bisphosphonate patients, the public is becoming better informed about these drugs and they are researching alternative methods to help them rebuild their bones. Physicians are also becoming more informed and are now more likely to better inform their patients as well.

It is important that your dentist know your serious concerns about this so he leaves no stone unturned during your surgery. It should go without saying that every surgical procedure should be done the same way, but unfortunately, that is not always the case. The extraction should be done with minimal injury to the surrounding bone, the socket should be thoroughly debrided of the periodontal ligament and all necrotic material, copious amounts of saline solution should be used to thoroughly irrigate the surgical site and the site should be closed with removable sutures.

Post operatively....... 24 hours later, start daily rinses with warm salt water at least 3-4 times a day and continue this for about a month. Supplements to stimulate the immune system like B complex, vitamin C, vitamin D3 along with calcium, magnesium, and boron, will help rebuild the bone. Actually, it would be wise to start these supplements now before the surgery especially since you are fighting an infection. A homeopathic form of Arnica sublingual pellets taken several times a day (starting now) will also help stimulate the immune system and then immediately after the extraction they not only help alot with post operative discomfort, but they aid in the healing process as well.

I really feel sad that you are dealing with this. There are alternatives to taking Bisphosphonate drugs that will absolutely not only prevent bone loss, but aid in the rebuilding of new bone. Most of the time, we need to seek a doctor who deals in Integrative medicine (traditional and alternative) to find a healthier solution.

Please try not to worry as it is so important to think positively. The infection is not long standing yet which is really in your favor!!

Please keep us posted on how you are doing.

Bryanna