... because there is a 10% chance the bone in the gum won't heal and it will cause me great deal of pain... what am I going to do? I am missing on having a bridge made because of this. When I will be able to have my tooth remove? I am a cancer patient.
I've been on Zometa infusion for 2 years.My dentist told me I won't be able to have one tooth remove
Question posted by luciagu on 18 Sep 2012
Last updated on 12 August 2019 by krogersmb
I had Multiple Myeloma 5 years ago and have been having Zometa since until 6 moths ago. I had 11 teeth break off at the gum lime and the other teeth are starting to look like they may break at anytime. I am schedule to go in the operating room for my oral surgeon to pull and cut all of my teeth at once since I have no choice due to getting possible infections. He said it will be risky but we all know going in. He explained if I do have gum/bone trouble, it will be very painful and very time consuming in the ICU and hospital stay if that does happen during healing.
I have been on Zometa infusions for 8-1/2 years. In that time I have had 3 teeth pulled and am now in clear correct braces. The only precautions we had to take was for an oral surgeon to do the extraction rather than a dentist. I also had to take antibiotics for 10 days after the extractions. The oral surgeon scheduled the extractions for a week before I was due for another Zometa infusion. That way the concentration of the Zometa was, apparently, lower. Of course, your experience can be different than mine, but I did well with the extractions. Additionally, the oral surgeon talked to my oncologist before extracting the teeth, so they discussed the pros and cons of extracting the teeth and agreed upon the precautions to take. I hope it all works out the way you want.
I am glad to hear about your experience, because I just went to see an oral surgeon and he said that because I had been on zometa 5 years ago I could never have a tooth pulled for the rest of my life. Told me that I would have to go to the expense of a root canal and then start a process to have it ground off and then let it push its way up and ground down again and keep this up until it finally finished pushing its way totally out. I need help from anyone who reads this and has had similar experiences. I need something that I can afford to do right now before this tooth gets infected. Thank you.
I truly believe that your oral surgeon should talk to your oncologist before saying that you can never have a tooth extraction. I have never had either an oncologist or a dentist/oral surgeon tell me that I could not have dental work/surgery except that I could not have the metal braces. That's why I got the invisalign. Many times dentists/oral surgeons are more afraid to do these procedures because of the Zometa. Yes, you would be more prone to infection, but a 10-day regimen of a good strong antibiotic will take care of that problem. If you do not have necrosis of the jaw right now, I don't know why they would be so adamant that you cannot have extractions. Your best bet is to get your oral surgeon to call your oncologist and they can agree on a treatment plan. I hope it all turns out well and you can get the dental work that you need.
I have been told the same thing over and over... absolutely NO pulling for the rest of my life! This results in expensive root canals and caps and grinding down for posts. painful. I develop sinus infections and fevers after every visit! In the process of seeing if there is a relation to Zometa infusions and the novicaine. Chemo rotted my teeth and I just got partial insurance to help get some work done but I was told I have a small window to do this before the next treatment.
Wow! I can't believe what these dentists and oral surgeons are telling you folks. I went to Moffett Cancer Center in Tampa, and have had 2 excellent oncologists since then. They all said that dental work, especially extractions, could not be done if any sign of necrosis of the jaw bone was present. Other than that, pre and post-treatment with antibiotics would be necessary. Talk to your oncologist about this. I have finished my treatment with the invisalign braces and am getting ready to get crowns or veneers on my front teeth. I'm sorry, but it sounds to me that your dentist might be trying to take advantage of a bad situation (you being on Zometa), or he/she is just scared to do the work because of infamiliarity with the Zometa.. I still am getting Zometa every 3 months and will for the rest of my life. I've just never had a dentist or oral surgeon tell me that I could never have a tooth pulled! Do they think the infection in that tooth will be less damaging? They just need to take precautions, that's all! I wish you the best outcome!
I am considering braces to correct my bite while on zometa. Could you share your experience with me? I have read that zometa will sometimes hinder teeth movement and hence stop the braces from working. Did you experience any problems with it? Wld be so grateful to hear from you. I can't find much information on this online.
Hi Misty! Yes, I finished with the Clear Correct braces (same as Invisalign) and all went well. It is true that because the Zometa strengthens the bone, the teeth do not move as easily. This added an additional 9 months onto my expected "brace" time. That was the only issue we ran into. Sometimes when it was time to get a new set of braces (usually every 2 weeks) the new ones were unusually tight, and thus uncomfortable for a few days. I just made those days soup and oatmeal days. Tylenol or Motrin worked well. I am now preparing to get crowns on my front 6 teeth. Had one crown on a molar done yesterday. I'm still confused about all of these dentists saying "No extractions!" Oh well. Best wishes if you decide to have the braces. I was just told absolutely NO metal braces --- only the Clear Correct or Invisalign.
Thank you for your reply. Its much appreciated. I am considering invisalign, hoping my treatment goes as well as yours
I would talk to the dr who is giving you the zometa and ask if this is true and what he would recommend.
Thank you kaismana...
after a sleepless night thinking about my problem, i came up with the same answer, to talk to the specialist that is giving me the treatment with zometa. I did call but he wasn't at the surgery today. I'll try tomorrow again y and will post his answer.
I'd be interested in what he says.
I had Zometa IV for 2 yrs as part of treatment for Multiple Myeloma. My understanding is that biophospates such as Zometa, particularly when done with an IV, does cause a risk of ONJ or "bone death." It is not caused by infection, but rather the bone is replaced with the biophosphates, and therefore the blood vessels within the bone are not there, so the bone will be unable to heal. It's like replacing living bone with titanium; it is hard, but if it breaks it has no way to heal because the bone is not supplied with blood like it used to be. Then in the mouth, the skin above the bone does not heal and bone is exposed in your mouth. Oncologists want you to tell your dentist because the dentist would try to do the least damage to the jaw bone by giving you a root canal and not damaging jawbone surrounding the tooth root as happens when teeth are pulled. I believe Zometa stays in the system for ten yrs.
after use, or it's about ten years before you don't have to worry much about it. My endodontist knew all about it. They try to keep you from having bad dental caries by using extra good mouthwashes, but that is to keep your teeth from decaying and needing intrusive work. I believe it is about a 10% chance of ONJ if you've had Zometa (or Boniva injections) but it is such a nasty problem, you REALLY don't want to take a chance. I may be wrong on the percentage of ONJ. A torus (bony growth on sides of gums or on roof of mouth) is another reason surgery might be needed in the mouth, so it is not only tooth pulling or accidents that result in surgery to mouth. They can't be sure whether someone will get ONJ after oral surgery; it doesn't happen to everyone who has had Zometa.
- Zometa uses and safety info
- Zometa information for Healthcare Professionals (includes dosage details)
- Side effects of Zometa (detailed)
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