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Thread: Osteoporosis

  1. #1

    Osteoporosis

    Anyone getting IV Pamidronate for osteoporosis or low bone density? If so, have you needed a tooth extraction or do you know how risky it is to have one? My son is having severe pain from a wisdom tooth and the new dental practice we are at do not want to touch it because of him being on the medication. I was never made aware of the possible ramifications if he needed an extraction. He is miserable and having a hard time. It hurts to open his mouth and when he swallows. He has some swelling starting at this point. He's getting Tylenol every 4 hours. He cannot have ibuprofen because of a bleeding disorder. I plan to call his PCP and ask him to call my sons old dentist(son got to old to continue seeing him), and see if he would be willing to see him or at least weigh in on the risks. But in the meantime I was seeing if anyone here has any experience with this that could share. Thank you.

  2. #2
    Super Moderator
    Join Date
    Dec 2011
    Posts
    748
    I'm sorry you're caught up in a medical dilemma that is not that common. It's generally pretty extreme to be fighting onset of osteoporosis and impacted wisdom teeth are tormenting your kid with the pain. I could easily be wrong but I suspect that you have encountered some extreme caution with your new dental practice.

    I am taking Reclast, a close cousin of your son's osteoporosis medication. To date, my dentist hasn't even asked me about it, although I did mention it to him the first year I took it. Reclast is a once a year IV infusion that usually puts me on the couch for a couple days with flu symptoms. In other words I believe that they are very similar.

    I hope your son can find a solution, it sounds like over caution, but Reclast and similar drugs have been found to have side effects that we're not accustomed to. My assumption is that you are trying to make sure his bone density is as good as possible. This is an important part of his life and his future health.

    One of the few issues of being diagnosed late that I am angry over is 52 years of untreated malnutrition and malabsorption. Osteopenia showing up in my early 40's and osteoporosis by 50 I could easily have done without. How you accomplish this dental work I believe will come down to the selection of the dentist. Keep up his skeletal health, osteoporosis can be astonishingly painful. A lesson I have learned over the last years is the additive nature of pain.

    I'm going to guess that a solution is at hand. It might take a conversation between dentist and doctor. Best of luck,

    LL
    66 yr. old man, DX CF 2002 by sweat test. Heterozygous S1235R revealed by genetic testing in 2003 & 2012 accepted secondary mutation. 7T, 7T polymorphism appears to be virulent.

  3. #3
    Junior Member
    Join Date
    Oct 2016
    Posts
    28
    Hello Jshet,
    How awful for you and your son! I'm sorry to hear he is in such an awful situation. My son (also Autistic) would be very upset if he were in pain like this. I briefly looked up the medication and saw this :
    Some people using medicines similar to pamidronate have developed bone loss in the jaw, also called osteonecrosis of the jaw. Symptoms may include jaw pain, swelling, numbness, loose teeth, gum infection, or slow healing after injury or surgery involving the gums.

    Did the practice mention exactly WHY they won't do the extraction? Have they worked on him in any capacity other than routine cleanings? I think you are doing the right thing asking your physician for some help. Anyone who has known your son for a while will be more compassionate and willing to do some extra research on your behalf. My guess is that they do not want to take on the risks associated with his special circumstances. He does have unique issues, but there has to be a doctor who is willing to help you...right? I pray that is the case because I cannot imagine how difficult this is for you. Prayers coming your way.
    Michelle

  4. #4
    Senior Member
    Join Date
    Oct 2007
    Posts
    224
    My son is not on that med but when his impacted wisdom teeth needed to be extracted he ended up having to get it done at the hospital. The oral surgeon tried doing it in his office but the sedation was not strong enough and my son kept moving around. We found out at the hospital that since he is on so many meds because of CF his liver metabolizes drugs pretty quickly so general anesthesia was the only option. Don't know if this helps but thought I'd share my son's wisdom teeth extraction story!

  5. #5
    Thank you so much everyone. I spoke to his endocrinologist, and he feels that If an x Ray is done, and there is no sign of disease in his jaw, then he has a low chance of developing it after the tooth is removed. But it is a possibility. I am going to contact his old dentist tomorrow and see if he will see us through this because he is very familiar with my son and Jacob really responds to him.
    it will definetly need to be done in the OR because he has to be put under, and the IV medication he is taking along with a bleeding disorder make it high risk.
    Toriimom, thank you for your kind words and prayers. It's comforting to know someone understands what extra stress it causes for him with the autism. I'm proud of how well he had done thus far, but he just keeps asking for me to make it better and it breaks my heart. His old dentist is amazing so I'm hoping he can help us out.
    thank you Littlelab, I always appreciate your input.
    thank you scrapper for sharing your sons story. I never knew about the liver metabolizing Meds quicker. That's a very useful piece of info for he to have here on out.
    ill let you all know how things go. Take care

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