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It is typically advised to avoid invasive dental treatment such as a tooth extraction while taking bisphosphonate drugs.
Compliance to oral bisphosphonates is suboptimal, with negative consequences of increased healthcare utilization and less effective fracture risk reduction. Extending dose interval increased adherence only moderately.
The action of bisphosphonate that is of concern to dentist is that they destroy osteoclast and without osteoclast there cannot be bone healing which is very important for surgical dental procedures like extraction or implant placement.
Dental Preclearance and Careful Tracking Can Prevent Osteonecrosis of the Jaw Due to Bisphosphonates. Bisphosphonates are an important part of managing bony metastasis of prostate, breast, lung, and other cancers but can cause osteonecrosis of the jaw (ONJ) in some patients.
Objective. Medication-related osteonecrosis of the jaw often occurs after tooth extraction; therefore, the withdrawal of antiresorptive agents for 23 months before invasive dental procedures is recommended, despite the lack of evidence on its effectiveness.
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People also ask

What happens if I need a tooth out and I take bisphosphonate medication? To minimise the risk of developing BRONJ we will routinely prescribe antibiotics and an antibacterial mouthwash which you will commence 1 hour before your tooth extraction and take for 5-7 days after your extraction.
Moderate risk of fracture: treat with bisphosphonate for 510 years, offer a drug holiday of 35 years or until there is docHub loss of BMD or the patient has a fracture, whichever comes first.
The discontinuation of bisphosphonate (BP) treatment before tooth extraction may induce medication-related osteonecrosis of the jaw (MRONJ).

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