Reclast and Teeth-Cleaning Appointments

I thought teeth cleanings were not a problem, only more invasive procedures involving bone, like extractions.

windyshores,
That what my dentist said, also. She was very reassuring about dental work and Evenity and Reclast. She said that if I needed a tooth pulled (unlikely) during treatment I would take a break from the drug until tooth issue resolved.
This has actually happened to my friend who is on Reclast. She seems to be managing this problem well.

Regular dental cleanings are not a problem even after the infusion, and it’s probably a good idea to have an exam prior to Reclast to treat any potential problems. Osteonecrosis (ONJ) is caused by a reduced capacity to heal the jaw bone in the case of an invasive procedure. I always inform healthcare providers about the drugs I’m taking even in the “off” years of Reclast.

If Reclast can reduce the capacity of the jaw bone to heal, how can we reasonably expect it to heal our bones from osteoporosis? Is it possible it only makes DEXA look better?

sallyj, nice question.
Is the fracture risk reduction rate also misrepresented in some studies by the role of BMD in FRAX risk calculation? Are the inorganic pyrophospate crystals deposited on the bone with the action of bisphosphonates opaque, or do they register density on DXA.

Osteonecrosis of the jaw is a rare adverse effect of bisphosphonates. But the mechanism of action of these drugs is in prevening the stage necessary for remodeling. We know that osteoblasts are most effective where the osteoclasts have cleared cracked and fractured bone. So we halt the regeneration of new bone and preserve older bone.

@sallyj2 Reclast doesn't "heal" osteoporosis, in the sense of healing a fracture or jaw necrosis. It affects bone turnover. So yes, over time, if taken too long, bone is not good quality. Some of us only use it to lock in gains from bone-builders but unfortunately bisphosphonates are often prescribed first.

Yes, understand.

Very good questions!

Thanks to everyone! The Endocrine Center confirms what's been said:
"To minimize a small risk of jaw infections, avoid scheduling your reclast in close proximity (within 6-8 weeks) of major dental procedures (not including routing teeth cleaning), or while you have an oral infection or toothache."
https://www.endocrinecenter.com/contents/educational-information/reclast-instructions-for-patients

But how do you take a break if you had a yearly infusion? Do you have to wait a year? If the tooth breaks/has root issues, it can't wait. Any suggestions will be appreciated.
I have delayed my Reclast as I am having tooth issues and the endodontist wants me to wait until May. That seems like a long time to put off treatment. But I am also very leery of any side effects as I have many allergies and a history of bad reactions to food/medications/immunizations/products and my current Dr does not offer low dose infusions or those with smaller doses more often.
Any suggestions?