After the dental surgeon did a 'collagen type ! C-Telopep [CTx] and I had gotten a good score over 250 [norm 40-465...that for a test I can find ever soo nothing about on the 'net' Humm?] And the doc was very HAPPY!
Can I go ???? duh? I'm scheduled for next month, neuro's given me clearance and no one seems concerned. I feel that this molar has to come out, but my question is WHAT NEXT?

I guess I have apprehensions even tho the surgeon seems to be well respected, and I feel that while he's not talked to my neuro, he's done some homework on immune issues and is not a stranger to them. I guess it's more the immune issues coming into play that have me concerned than dental? I've had LOTS of dental work done in my life, and thought I'd experienced a LOT? I am learning that I maybe because of the immune-ness have only touched the iceburg! I've never gone into a dental surgery with concerns before, but then last year I'd not gone into major cancer surgery before either. Things are improving in all these quarters, but I sure wish there was more cross-communications? I've tried, but other than brandishing a 2"x4"x6' I probably wouldn't get anyone's attention, other than being committed? Thanks for an ear - j

Hi J,
Here's some basic information on the CTX (C-Telopeptide).
It is a lab test (urine, serum or plasma) that measures osteoclastic activity. Osteoclasts are cells that break down bone and cause resorption to occur. In oral surgery, a score over 150 is generally considered safe enough to proceed with surgery. However, individual medical risk factors other than bisphophonates need to be taken into consideration also. One main thing to keep in mind is......... any oral infection will compromise your immune system.

It is recommended by the ADA that any patient who's been taking an oral bisphosphonate for longer than 3 years should have a CTX test prior to any oral or perio surgery. It is also recommended that a drug holiday be taken for at least 3 months especially if the test score is not greater than 150 pg/ml. However, this drug holiday seems a little bit skewed since the half life of these drugs are 10 years. But that's the general recommendation at this time. For people who score over 150, the holiday may be less depending on other current health risk factors.

There are many conflicting opinions about osteonecrosis resulting from the use of bisphosphonates. Being in the dental profession, I can tell you from my experience there are two main reasons for the confliction of opinions.

One is the general dental profession has basically been ignoring osteonecrosis of the jawbone when associating it with medications, infected root canaled teeth, and autoimmune disorders. Since the information about osteonecrosis has become more public due to the internet, the dental profession is now starting to take a closer look at their patients. However, dental schools do not teach general dentists how to recognize the early signs of osteonecrosis or how to properly treat it. Oral surgeons learn about it on their path to becoming a surgeon, but they all have their own method of treating it.

Secondly, bisphosphonates are a HUGE profitable business for the pharmaceutical industry and they are not about to let the public know the extent of the side effects until the public forces them to release that information. About 5 years ago, a dentist friend of mine did a seminar for one of the pharmaceutical companies that manufacture bisphosphonate drugs, about the correlation between osteonecrosis of the jawbone and bisphosphonates. His particular practice was limited to oral surgery, so he brought along a very elaborate slide show of some of his patients demonstrating that pictures are louder than words. His audience, which represented various departments of this drug company as well as physicians and dentists, were enlightened by his presentation and asked him to come back to do another seminar for those that were not in attendance on that particular day. Well, shortly thereafter, he was notified by the marketing team of that company that they were not allowed to print or discuss his findings until further notice because it could cause a huge public upset which would result in a financial loss of multi millions of dollars.

So what is currently happening ........ the information is getting leaked out, thus the public is becoming more and more aware as we seek information on our own. What does this say for people like yourself who have been taking these drugs?? Become as well informed as you possibly can and keep questioning your physicians about alternative methods in treating your medical problems. We can't turn back the clock or reverse the damage that has already occured. But we can hopefully take measures to minimize or prevent further deterioration in the future.

J, make sure that your oral surgeon and your physician are on the same page and they agree if you should or shouldn't stop these meds and for how long. In the interim, do everything you can to keep your immune system healthy through proper diet and supplements. This doesn't mean double up on vitamins....... it means be diligent about taking the appropriate amounts daily without fail. I think we may have talked about this in the past but I'll reiterate it here....... Calcium needs vitamin D3, magnesium, and boron to absorb properly. Vitamin C helps build collagen and vitamin K1 and MK4 have been proven to reduce bone loss. Here is a link about some of these things:
http://www.thedoctorwillseeyounow.co...tion/vitak_20/

J, if the tooth is infected or is causing periodontal bone loss, it is best to have it removed. I understand your concerns and can tell you without a doubt, that taking certain steps before the surgery and afterwards can help ALOT with the outcome.

Please keep in touch here and let us know how you are doing ~'.'~

Bryanna