Should I be concerned?

[SylvanMoon]

I've been on Alendronic Acid for several years (both currently and over the last two decades with breaks inbetween). I slipped into the osteoporosis category two years ago, but have had no related breaks so far. In October my NHS dentist determined that I should have two teeth extracted and because there is risk associated with having taken Alendronic Acid (which, as far as I can understand, does something to calcium in the jaw) put in a request for the extraction to be done at the hospital under the Maxillofacial oral surgery team. When I heard nothing by mid-December I asked the dentist what was happening. They assured me the referral had been sent and was acknowledged to them. They gave me the YAH number so I could track the referral. That link had a phone number to call. So I did, to ask why I'd not heard anything and to enquire what was happening. The woman on the phone (who I assume was secretarial) said that the service in my local area was being refurbished, but it I was willing to travel, she could give me an appointment for the following week. I thought this an odd way for things to dealt with, but accepted the appointment. It turned out to be an oral surgeon in a dental surgery who did extractions under general anaesthesia. I informed him that I was there only because of the Alendronic Acid issue and that I opted for local anaesthetic instead. He said it was no problem and that the only issue with Alendronic Acid is that the healing might take longer than normal. So he extracted the teeth. The extraction site has healed and my dentist is going ahead with the dentures.

But yesterday I got an NHS referral letter inviting me to a consultation appointment with the Maxillofacial department at the local hospital. They had no record that I'd already had the teeth extracted. This appointment is now cancelled, but I'm a bit concerned that whatever it is that is supposed to be carefully dealt with during an extraction due to Alendronic Acid hasn't been. Am I worrying unnecessarily or is there something I should be on the lookout for to alert someone to should problems develop later?

Hi! The problem with dental extractions when taking alendronic acid is the potential for medication-related osteonecrosis of the jaw (MRONJ). Dentists will try to extract the tooth hopefully causing as little trauma as they can however this can sometimes be unavoidable. We always try to save teeth first if we can by root canal rather than risk MRONJ but this isn't always possible. The dentist should consider regular review of the socket to check for signs of poor healing and possibly xrays if indicated to check the underlying bone. If you are visiting the dentist regularly for dentures they are likely reviewing the socket and will notice anything suspicious. Most people dont have problems its just something to be aware of when planning extractions. Any questions I'm sure your dentist would be more than happy to help x

Thank you so much for that explanation. There wasn't enough of the tooth to save apparently (it broke off when eating corn on the cob!, but looked as if it was on the way out for quite a while) and I suggested that the one next to it (which looked in a similar state) be extracted at the same time to limit the trauma should that have to undergo the same fate. My dentist seems to be happy with how it's healing and I was scrupulous in following the aftercare of the extraction. I would hope that it's okay.

Yes sometimes teeth just aren't restorable after fractures, you are most likely fine now if it seems to have closed over and no further pain or problems. Wouldn't hurt to get some reassurance from the dentist next time you are there but seems like you have been doing everything right. All the best to you x