Medication related osteonecrosis of the Jaw by Dr. Matt Koepke

I’m now afraid to take Rapamycin orally. I came upon this video when researching Osteonecrosis of the Jaw because I had taken Fosamax in the past and was getting some dental work and wanted to check the latest info. In the video it mentions Rapamycin also being a trigger but with a much shorter half life. Interesting video. Thought it worth mentioning. I’m considering just using my remaining pills to make the topical Rapamycin cream. Just saw the recipe.

1 Like

Osteonecrosis not listed as an adverse reaction of Rapamycin, and I don’t see Rapamycin listed in any of the literature.


Osteonecrosis is a potential side effect of fosamax after extraction which can last up to 10 years after stopping. Want to keep your teeth healthy? Stop eating carbs, all of them including fruit and “slow carbs”. No carbs no decay and no periodontitis.


This research is on very sick / renal transplant patients typically taking many other medications and on high/daily doses or sirolimus. As with all this type of research, there is absolutely no indication that it applies to healthy people taking lower/pulsed dosing of rapamycin / sirolimus. And it seems to be less of an issue than it once was even for this sick population of people…

The incidence of osteonecrosis or avascular necrosis has fallen as a result of new advances in immunosuppression and lower corticosteroid regimens. Mycophenolate mofetil and sirolimus are associated with an increase in surgical complications. Sirolimus may also be associated with avascular necrosis in patients after renal allograft transplantation.

They say having taken Fosamax is a danger in developing Osteonecrosis of the Jaw IF you are having a tooth extraction or possibly even a root canal. MAINLY if you had taken it IV for cancer. Being an older lady veteran who uses the VA for my dental, I have been given warnings about getting an extraction and it’s possible consequences by both my periodontist and my dental hygienist who has had 3 lady veterans who developed Osteonecrosis of the Jaw and had taken Fosamax only ORALLY. Very few lady veterans and even fewer with dental benefits. I’m just saying be aware and willing to take your chances. Considering Osteonecrosis of the Jaw is presently incurable, and for many years it was not mentioned as a possible consequence of taking Bisphosphonates, therefore not mentioned in their side effects, I stand by my warning.

1 Like

Did you watch the video?

Could you please point to the approximate minute about rapamycin? The lecture is quite long, mostly about dental surgery, and due diligence of a dentist. I tried moving forward little by little, to catch the snippet, but couldn’t catch it.

Thank you.

The half life of Fosamax used to be 10 years now 12. Half life. Fortunately with Rapamycin , if you stop and wait 6 months before any dental surgery you should be fine.

This includes extractions. Possibly even root canals. As for giving me advice as to my diet, I am 67 and only missing one tooth and get regular dental checkups. Probably not bad for my age.

Six months? Where does this 6 months suggestion stem from?

The video I put previously in this thread.