Took Fosamax: Any Precautions to Take before Getting Implants?

Fosamax is a bisphosphonate. This group of osteoporosis treatment drugs has been associated with BIONJ (bisphosphonate induced osteo-necrosis of the jaws). The mechanism, slowing osteoclast activity (cells that tear down bone), prevents bone turnover and thus maintains bone density. This also affects bone healing. 1% of patients taking these medications will experience BIONJ, which is more prevalent with I.V. administration. Alveolar bone (suporting the teeth) has more rapid turnover and is thus susceptible to BIONJ. The risk for BIONJ increases after three years of bisphosphonate use. You should be concerned. Serum CTX is a routine annual test for bisphosphonate users with 3 or more years of use. A serum CTX 150 - 200 pg/ml is considered low risk. A drug holiday (9 months) has been recommended to allow osteoclasts to repopulate. Changing to non-bisphosphonates : Salmon Calcitonin, Raloxifene, Forteo has been recommended. Do not proceed without addressing these issues with your surgeon and reviewing a BIONJ consent form.Good LuckTheodore M Grossman DMD