Hi Cheri, welcome... It is pretty normal to have crowns replaced every 10 years or more.  If a crown only lasts 5 years, then I would try to find out why since it really should last longer than that.  Since you are taking Reclast, the recommendation is to avoid invasive dental procedures which would be extractions and other surgeries involving the bone.  Having a crown replaced is not considered invasive, unless for some reason the oral surgeon has to cut into the bone, but that's not the norm. A root canal is also not an invasive surgery either since it's the removal of the nerve tissue of the tooth and the jaw bone is not involved, except in rare cases.

So considering having all your teeth pulled, while on Reclast, is not recommended.  Is there some way you could deal with these problems by either replacing a crown, putting on a new one, or having a root canal/crown?

I would worry if an oral surgeon recommended extracting all my teeth while on Reclast because you'd have so many areas that need to heal in the jaw bone, and your healing process may be compromised from the drug.  I personally would not opt for this solution and would be surprised if an oral surgeon recommended it while on Reclast.  Try to do whatever you can that doesn't involve "invasive" surgery--cutting into the bone like with extractions.  There's also a procedure where they remove (amputate) the top portion of the tooth, leaving the roots and lower tooth in place within the bone.  This can be done with cracked teeth, or infections if the removal gets all of the infected tooth.  This way you aren't distrubling the jaw bone and then you can have a crown seated afterwards, and again it's not considered invasive, the one thing you want to avoid.

If your insurance will allow this, you could also think about getting several opinions to find someone very knowledgeable in this area of bisphosphonate use and dental procedures.  Try to keep your teeth as long as possible by using one of the above options.  You may have to discuss a drug holiday from Reclast as well, but that's entirely up to you and your Dr.  If you do have to have a tooth pulled, because there's no other option, ask if you can have a blood test called CTx which will tell the oral surgeon the state of your bones and their ability to heal.  If you need more info on CTx, just let me know.

Good luck with this, and I hope you don't have to have all your teeth extracted.