Hi @sando, I’m just going to be upfront with you right away. I have no personal experience with any of the bone loss drugs so I can’t comment on what your next step is concerning your meds. Actually, no one in the forum would be able to do that for you. 😉 We can share our personal experiences and use our knowledge to help out…but not to diagnose or treat. That’s a discussion you need to have with your doctor or endocrinologist. With my 30+years experience in the dental field I feel comfortable with talking a little about dental procedures while taking osteo drugs.

It’s a bit of a shock that your dentist and oral surgeon don’t know much bone loss drugs. They’ve been on the market for years. There are many seminars and papers on these drug for dental professionals because they can complicate surgeries and dental treatments. Bisphosphonate drugs like Evenity may impact the normal reparative process of the bones which can be risky for procedures such as surgical tooth extractions, implants, and bone grafts.

In your case, with your oral surgeon suggesting that the bone support in your mouth ‘isn’t the greatest’ I’m concerned that it may not be in your best interest to have a bone graft done with just getting off the Evenity treatments. The risk of failure of the graft might be elevated.
So his suggestion of having the 3 teeth removed and replaced with a partial would be the more practical of the options. Then after about 6 to 8 weeks of healing, you’d be able to start your Reclast with your doctor’s ok. Also, with a partial, you wouldn’t have to wait to start the tooth replacement process. As soon as the gums are healed you could start with the impressions to make the partial denture and have that completed relatively quickly.

I’m expecting with your oral bone loss that the remaining teeth wouldn’t be complicated removals. To minimize the risk of infection your oral surgeon may have you rinse right before the procedure with an antibacterial mouth rinse such as Chlorhexidine. You may ask if you’ll need a prophylactic treatment of antibiotics as well. If you’re having issues with these teeth, such as periodontal disease which can harbor bacteria, then having the teeth removed now is better than waiting.

Having a partial denture made to replace your teeth might be a better fit for you without having to worry about the cost, time involvement and bone consideration for implantation.
Talk this over with your dentist and get estimates for both.
What are you most concerned about?