Patients with Multiple Myeloma

Your oncologist may have started you on a medication to help with your bones. This group of medications are bisphosphonates and most of the time it is administered in an IV form. There are two names which include: Zometa and Pamindronate. Visiting the dentist is extremely important as this medication can affect future extractions.

Bisphosphonates stop bone remodeling and turnover. This means that if teeth need to be extracted then there is a high risk that the sockets will not heal properly, leaving bone exposed and could lead to both acute and chronic infections, specifically medication-induced osteonecrosis of the jaw (MRONJ).

This is why it is imperative to see PMH dental clinic either before the start of IV bisphosphonates or at early number of doses. One of the PMH dentists will complete a comprehensive exam and have a discussion about this medication and tooth extractions, if deemed necessary. Moving forward, recommendations include: no extractions, no implants, no surgeries. Acceptable dental procedures include: fillings, cleanings, crowns and root canals.

Can I have teeth extracted if I have been on IV bisphosphonate for years?

Ultimately, the answer is no. At this stage, there is a high risk that the socket will not heal properly and will lead to medication-induced osteonecrosis of the jaw (MRONJ). If a tooth infection is present, a root canal will be the treatment option of choice before extracting the tooth.