From the Research
It is recommended to wait at least 7-10 days after a dental extraction before resuming alendronate, as this allows for initial healing of the extraction site and formation of a blood clot, reducing the risk of osteonecrosis of the jaw (ONJ) 1. When considering the resumption of alendronate after a dental extraction, it's crucial to weigh the risks and benefits, particularly the risk of ONJ, which is a rare but serious condition. The studies provided indicate that the risk of ONJ is associated with the use of bisphosphonates like alendronate, especially after tooth extractions 2, 3.
Key Considerations
- The risk of ONJ is increased with long-term use of alendronate and after tooth extractions 1, 2.
- The overall incidence of bisphosphonate-related ONJ is low but significant, ranging from 0.7% to 12% 3.
- Recent and long-term use of alendronate is associated with an increased risk of surgically treated ONJ 2.
Recommendations for Resuming Alendronate
- Wait for at least 7-10 days after a dental extraction before resuming alendronate to allow for initial healing and reduce the risk of ONJ.
- Follow standard administration guidelines when resuming alendronate: take it first thing in the morning with a full glass of water, remain upright, and avoid eating, drinking, or taking other medications for at least 30 minutes afterward.
- Consult with both your dentist and the prescribing physician before resuming alendronate after dental work, as individual circumstances may require adjustments to this general guideline.
Additional Considerations
- Teriparatide has been shown to be effective in the treatment of medication-related osteonecrosis of the jaw (MRONJ) and may be considered as an adjunctive treatment in some cases 4, 5.
- The management of MRONJ is challenging, and standard treatment guidelines have yet to be established, highlighting the need for careful consideration and consultation with healthcare professionals 5.