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  #1  
Old 04/16/10, 11:19 AM
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Join Date: Oct 2004
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Actonel and getting tooth pulled

This is long. I cracked tooth #3 about three years ago. I had one root canal that failed twice and vowed I was never having another--terrible pain for days when the root canal failed. My initial thought was to have the tooth pulled, but since getting a crown was only $100 more and since the dentist said he thought that was all I needed, I went with the crown. The thing has been sensitive since but hasn't really hurt. Earlier this week I thought I had a terrible sinus headache for three days, but now I notice that this tooth is sore when I bite on it, so I decided it was time to get it pulled. Called the dentist my dentist refers to for extractions. Found out that since I take Actonel I'd have to go to the doctor and have a C-telopeptide test which costs $190 and is not covered by insurance. If the level is not at least 150 I can't have the tooth pulled because my jaw might not heal due to the Actonel. Monday I'm going to my husband's dentist. I went to him one time (didn't go back 'cause he is not patient and scares me) and he suggested making a new crown because this one does not fit under the gum line and possibly sending me out for a root canal depending on what he sees when he takes off the old crown. Dh swears this guy is a great dentist despite his manner, so I hope I'm doing the right thing. Anybody else take Actonel or something similar? I had a bone density scan and my hip bones were really thin, but I'm wondering if this stuff is safe to take.

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Old 04/16/10, 11:46 AM
 
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Actonel, while safe for the most part, has been linked to jawbone destruction during oral surgery. Something in it that helps your bones for the most part, somehow makes the spongy bone of your jaw weaker and less likely to heal properly.

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  #3  
Old 04/16/10, 04:10 PM
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considering the complications you face because of Actonel and its side effects (bone necrosis= bone death) it would be highly prudent to do everything you can to avoid having that or any other tooth removed.

In my experience, I would recommend you:

First, call the dentist who did the root canal and crown. Root canals are not necessarily one or even two shot deals - some root canals require treatment, further treatment, additional treatment and sometimes REteatment in order to get all those dern twisty and curvy canals cleaned out - and even then, the tooth may too far gone to save. But a root canal is your last chance to save it. A crown restores the structure of the tooth and keeps it functioning.

If you are having sensitivity when you bite down - it COULD be a sinus infection or swelling as the swollen sinus pushes down and puts pressure on that tooth, adjacent teeth and that whole area.

A new crown that is sensitive is sometimes just a matter of adjusting the height and fit of that crown. A simple 5-10 minute adjustment.

Your dentist may need to send you to an endodontist to retreat the root canal - it is quite easy for a general dentist not to be able to access all the canals fully - root canals are not that easy.

If your crown does not fit well - I'd certainly be back at the dentist who did it insisting that he redo the crown.

We have not seen good results with extractions and Actonel in oral surgery.

If extraction is at all avoidable - I'd recommend the alternative first.

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Last edited by Wind in Her Hair; 04/16/10 at 04:12 PM.
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Old 04/16/10, 05:40 PM
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Thanks for the information Wind in Her Hair. I have another question. I've taken Actonel 8 months. I've read that some dentists recommend stopping it three months before having a tooth out. If I stop taking it will I ever get back to where I was? I've also read that it stays in your system 10 years. At my age it's possible that some time I won't have any choice but to have a tooth out. I started taking the Actonel without doing any research when the Nurse Practitioner recommended it after the bone scan came back with thin bones in my hips. Since this has happened with the tooth I've been reading about Actonel and have decided I'm not going to take it any more. According to some studies these types of medications haven't been proven to prevent hip fractures and there have been serious problems with them in other areas as well as dental. Now I almost feel as if I've been taking poison.

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Old 04/16/10, 06:06 PM
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mellba, I have little useful advice, but as someone who's had experience with cracked teeth, extracted teeth, teeth that have been knocked out, root canals, and osteoporosis, let me say that you have my COMPLETE AND TOTAL SYMPATHY.

If you could find an endodontist who has a microscope that allows him/her to make sure, as Wind in Her Hair says, that the "dern twisty and curvy" canals get cleaned out, that would be a plus.

Also, some dentists and health care practitioners recommend having the canals filled with materials other than Gutta Percha, which is most commonly used in root canals.

They feel that Gutta Percha doesn't completely seal the canals, so a tooth being treated with it could become re-infected, and the root canal would need to be re-done. But having a root canal done with newer filling materials (Endocal, Biocalex) is very, very pricey.

Arrgghh, it is bad enough having to go to the dentist without going to one with a crummy chairside manner. Many hugs and best wishes to you. Here's hoping your tooth sensitivity is due to something else (is the gum around that tooth inflamed?) I'm with Wind in Her Hair on doing everything possible to keep from having the tooth pulled.
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Old 04/16/10, 06:47 PM
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Thanks for the good wishes country bred. The gum isn't inflamed. I'm such a chicken when it comes to the dentist. That's why I've gone to the one who made the poor crown for so long. He has a very soothing manner. Dh says, "Would you rather go to someone who calms your fears, or someone who does a good job?" I'd like to find someone who does both.

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Old 04/16/10, 07:08 PM
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Mellba, don't be too quick to jump off the Actonel bandwagon - you need to consider everything and discuss this with your doctor.

Yes, taking Actonel makes you a more complicated oral surgery risk - but it does not necessarily mean that -with proper precautions and knowledge of this beforehand -that your condition can't be handled or that oral surgery will result in bone necrosis.

ALL medications carry with them associated risks -which we and our physicians need to weigh carefully before committing to.

And osteoporosis may be a MUCH greater risk for you than the possibility of having oral surgery or oral surgery complications and risks.

I knew a woman who was opening her window to bring in some lovely springtime breezes and as she gingerly lifted the window up, she broke three vertebrae - due to her osteoporosis.

What would have happened to this woman if she had taken a fall or been in a car wreck?

I would think the chances of taking a fall or stumbling or tripping would be MUCH higher than the risk of having to have a tooth extracted.

Before you decide anything, please discuss this with your physician -THEN make your decision.

As to the eventuality of having to have a tooth extracted, we see patients in their 90s all the time that have every last one of their teeth in their heads. In fact, last week, we saw a woman (one of my favorite patients) who is 99 -about to be 100 - who has never lost a tooth.

With proper care and a little luck, you might be able to avoid losing any.

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Old 04/16/10, 07:50 PM
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Thanks WIHH. From what I've been reading though Actonel sounds like bad stuff.

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  #9  
Old 04/16/10, 10:11 PM
 
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Actonel user here for several years. I've had 6 teeth pulled all at once for my partial denture in the bottom. I've had 3 teeth pulled in the top. I've not had any problems with healing, jaw bones or anything else.
I took my meds right on schedule, never pausing before having teeth removed.
I can't tolerate Fosamax, so actonel works well for me.

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