Does anyone know if I can get dental work done before starting reclast

Sando, I find your thinking clear.
ONJ is least common with Evenity. And most common with injected bisphosphonates. And most common when these medications are given for cancer metastasis to the bone. At 64 days you are losing or have lost the effect of Evenity. It doesn't clad to bone the way bisphosphonates do.
You probably have all this figured because you've come to the perfect conclusion--on your own. But:
Bisphosponates lower new bone growth and preserves old bone. The blood supply isn't maintained in bone that isn't growing. That in turn affects the vascularity of the epithelial surfaces of the mouth. So oral wounds don't have the blood supply to repair themselves. And of course the bone itself can't repair itself. ONJ is difficult to treat. Forteo is often used propholactically with dental work. And is the standard treatment for ONJ and ATF (atypical femur fractures) Even though it hasn't been used following Reclast, three months of Forteo, in my calculation, would be a great advantage to your bones as it initially greatly increases osteoblasts while the withdrawal of Evenity increases the osteoclasts.
The onset of ONJ with Evenity is usually within 30 to 40 days.
In your position I would get bone markers, start Forteo, finish dental work and wait 2 months after dental completion. If you can get bone markers, I'd get them at one month of Forteo to be certain that there was no general bone loss and at two month to see if my bones would be better off with Forteo than Reclast.
I think you are pretty safe, anyway. And I don' t know anything.

I should have you as my doctor. Your advice sounds reasonable. I have endo doc and Arthritis doc. one of the doctors I have said "Prolia and Reclast are the best options. Insurance would not pay for Forteo following Evenity since it is considered dangerous to use two anabolic drugs. The theoretical problem with excess anabolic drug is bone cancer." I am concerned about what meds I take and looking for the least harmful solution, I do appreciate any knowledge that you can provide.

sando, you be my doctor, and I'll be your doctor and we'll have the strongest bones in the world.
I hadn' t found a reason anywhere. but if excess anabolic drug is the concern, why can you take Tymlos or Forteo for extended years. I wonder if the one doctor is thinking of anabolic steroids or stuck in the black box. Maybe the information about the last 9 months of Evenity being antiresorptive is a secret.
Would your oral surgeon prescribe Forteo for you to aid the surgical healing?
I might try for an oral bisphosphonate. But then I might not take it. The injectibles deliver a lot more of the medication and all at once.

Between Prolia and Reclast I'd choose Reclast (but not now). But I'd ask for 4mg instead of 5. Have a long infusion with IV hydration And I'd only take one shot since the gentleman who coducted the clinicals on Reclast says one is good for two years. I'd try to get bone markers before and at the three month on Reclast.
Or I'd go to Bogota and get Forteo pens for 100$.
I can't see that even one person has followed Evenity with Forteo.

Guess what @gently! I just saw a message addressing my questions about choosing Forteo ..she prescribed it she says 8 days ago and I checked Accredo but nothing ready..hmm is the RA doc right..the insurance won’t cover it? All kinds of thoughts are buzzing around me…did you say there is not one person taking Forteo after Evenity ? Ouch..that kind of blows my plan? I’m no doctor and wish I knew more !! (Thanks for saying we can be each others doctor…I think people are our best doctors !)
It’s a good question as yes those other meds SRE taken for two years..I don’t get that either…today I had to get my teeth pulled..not all..but I’m juggling when to start another med…by evenity standards it should be before July 31st. Sooooi agree on reclast but it feels like a trap…it’s one shot for the year…worried about possible side effects and then…we are stuck if something comes up…do you see many problems from other reclast users? This RA doc that sent the strong dissent over Forteo seemed to know more than the 2 endos..at least she surprised me by answering!
Well gotta take a tylenol for bedtime…thanks for writing! Was hoping you would!

@sando, oh pioneer, cheers to the prescribing practitioner. Cheers to us. Well, it makes me cheerful to read this message.
I see Reclast the same way you do. Still, it's easy and really most people don't have tooo much of a struggle with side effects, but those that do give us caution.
My dislike comes for Reclast comes from the long lasting blunting of anabolic effect and the avascularization of the bone saved.
I'd bet that you won't experience the blunting from Evenity. though I've read of it, it doesn't make sense to me.
I hope you are being prescribed bone markers before and at two months with Forteo. And pray for no side effects. I would still want to take Forteo for the jaw for at least 3 months.
If the insurance approves, be sure and check Lily Cares for any discount. If the insurance doesn't approve RX Advocate might. If you make too much money to qualify for either, it's helpful to check Good RX. With Good RX it would be a generic Alvogen teriparatide. I use the generic intermittantly.
I hope you get implants, even if it's the minis. You'll love your teeth. If you go for dentures, you should never take bisphosphonates, which is a good idea anyway.

@gently I just had some teeth pulled yesterday so I’m in La La land but am glad you felt cheerful! ( Im back to is this possible!! Jitters.
I’m now wanting to make sure I know ..some of your thoughts! I’m trying to mentally be prepared for the best back up for Forteo as we checked and no prescription yet! ( is the RA doc right..? Will it pass?) She’s pretty definite..but the 2nd endo asked if I’d heard from them about the prescription and I told her not yet! The bone markers…is that basically I need to get a scan before starting Forteo and then again 2 months later…it will tell me if Forteo is
working? On the implants I did ask the oral surgeon if there were any of my teeth that could take implants…she said no I would not recommend implants for you…
( that’s all she wrote as she was in her regalia ready to start!) what are minis? …gosh there’s so much I don’t know! There’s one on the side almost visible so I was thinking of that one especially….

Well that’s enough for you..I’m glad I am able to ask you questions as my docs don’t dialogue!…leading to anxiety!! So it’s such a relief! Best!!

@sando, how is it over there in la la land.
There is a generic for Forteo Alvogen teriparatide that may cost less than a copay without using the insurance. Insurance companies try everything to avoid paying. If your insurance refuses, your doctor will appeal. You might check RX Advocates. Not sure, but I think it costs 70$ a month. See if your income is in range. They'll tell you on the phone. 70$ is probably lower than the insurance co-pay.
The oral surgeon may not be recommending implants because she doesn't do them. It requires special training. She may be thinking that you don't have enough bone. This is where the minis come in. They basically have a shorter anchor. Some say they don't last as long, but I've seen where they last 30 years in a low bone jaw.
844-559-8330 RX Advocates
It's hard to ask question with your mouth full of tools. Are you having nitrous oxide.

Lala land is getting better ..3rd day already..quick question: I’m not sure whether when I reply to you, it is better for you and me just for me to hit only reply. A few times I pressed reply and also posted…not sure if theirs a protocol. Is it okay to just hit reply as I’m focusing on speaking to you now. I’m not needing a wider audience as I did that that and got responses. S.

PS: I wondered what you thought as I wrote down the strict doc’s latest opinion. Not such good news for me.

PS: The surgeon only does surgery..meaning no implants..( she said I’d hate to see you in implants. ( why ? I’ll try to ask…she may have seen something weak in my tooth bones) My basic dentist does do partial’s and he does also does the flexible partials that are supposed to be well, more flexible and comfortable according to ONE article I managed to read. Minis! Never knew…went to one who said he could maybe do a bone graft of some kind..as my one bone we were discussing didn’t quite make the green light…and it will be more $$ too. He thought partials and so did the everyday dentist.

I think hitting reply isolates the answer, so we don't interrupt the thread violating the original question. Using @gently places a post in my mailbox in case I don't look at Mayo Connect. And you can use the PM feature.
The bone grafts were originally for weaker or more shallow bone. But now they almost always place a bone plug or graft, when they pull a tooth, if you are planning on implants.
Those implants are wildly expensive. The minis were once less expensive.

I don't think the strict doc has the information in order. It is really difficult to keep up with the research on even one disease.
Oh, the bone markers are a serum draw P1NP and CTX. I would want them to decide if I'd rather continue on Forteo or if Reclast would seem more advantageous. They are generally used to determine if a medication is actually helping the bones become stronger. The DXA is important, but it is better not to wait a year to find out that a medication isn't building your bone.

It can be stressful to have a lot of dental work at the same time.

Hey@gently…I’ve been overwhelmed but wanted to update you, as I remain scared…despite telling fear to go away! I got the Forteo delivered to me…and I have 2 docs saying it will ruin your health ( bone cancer) and one saying ok…with no citation as to why it’s ok. I’m
concerned as I’m no dr and it ends up as me making the final decision on the basis that I’m guessing Myclast and Prolia are dangerous…I’m uneasy. It’s now over 60 days since I last took evenity…please summarize again what you know and who I might call…I’m in shreds of worry…but have to act now…fear coaches has taken over…please help..Sandy