Did I make the right decisions for Osteoporosis & Bone Health?

I went to my dentist today because my crown felt loose. he took an x-ray and told me he was unable to help me because the tooth under my crown was fractured and he could not remove the crowd because I was on Reclast for osteopenia. He advised that I just leave my crown loose . He said if we remove the crowd I would get it a severe infection. I needed to see an oral surgeon. Does anyone understand the complications of using reclast and jawbone health?

Hello @lcyphers and welcome to the Osteoporosis Support Group on Mayo Connect. On Connect, we have a discussion about dental work while on Reclast. Here is the link to that discussion. As you read the posts in this discussion, feel free to ask questions of those who have posted. Just click on "Reply" and then ask your question.
--Dental Work While on Reclast
https://connect.mayoclinic.org/discussion/dental-work-while-on-reclast/
Also,
--Reclast and Teeth Cleaning Appointments
https://connect.mayoclinic.org/discussion/reclast-and-teeth-cleaning-appointments/
I would also like to invite @loribmt to this discussion as she might have more information to add. As this is your first post, I'm wondering how long have you been taking Reclast and if it has helped your bone loss?

Chris, thank you for the information. Do you need to be an in state resident in order to do a Mayo virtual visit? I just had REMS done and I have a 5 yr risk of major fracture of >100%! I am in shock and afraid to move literally. I am 78 and live in Florida and have only been able to secure a visit thus far with an NP in an endocrinology office that does not specialize in osteoporosis. I am thinking also of booking a virtual with Dr McCormick. I am grateful for any and all suggestions and information. Thank you!

Here’s a stupid question coming, @lcyphers - if the crown is loose, is there no risk for it becoming infected or falling out?

My endodontist was able to save a molar for me with a re-treatment of a previous root canal (the root was not fractured). But I seem to remember that there are other procedures that might help you. Perhaps see an endodontist for a consult/second opinion.

The problem with Reclast and some other OP drugs is that they can inhibit the blood supply and healing process of the jawbone after invasive dental procedures.

Best wishes!

@zooie ,
I am so sorry you have had this surprise diagnosis! If the Mayo virtual doesn’t work out, and you are near Orlando, Orlando Health has a women’s health pavilion in Winter Park with a doctor who specializes in bone health….Blessings to you and prayers for your good health.

Good evening @zooie. I don't think you have to be an in-state resident. Sometimes, medical professionals for out-of-state residents can arrange virtual visits with Mayo Connect staff.

Good luck with your decision.

Chris

Thank you Chris and Babbsjoy for your information.

My 8/16/22 DXA showed the following T scores:
right femur neck .5
right total hip -.5
left proximal radius -2.6
lumbar spine - not valid due to degenerative changes

My 7/16/24 REMS
spine -3.5 fragility = 62 5 yr risk >100%
left femur -3.6 fragility = 54 5 yr risk >59%

Hence I've been in a state of panic. I've read much of "Great Bones" and also learned alot from this blog. Thank you all! What an amazing resource!

Today I met with the NP at a local endocrinologist (Naples, FL). Surprisingly the meeting went well. She recommended Evenity; however I fear the side effects - especially as my husband has cancer and I am the caretaker. I requested Tymlos, which she agreed to. She also agreed to request the baseline CTX and P1NP tests.
So thankfully I think I won't be needing the virtuals with either Mayo or Orlando Health. However I may still want to do a virtual with Keith McCormick - I'm shocked at the extreme degradation in less than 2 years.

Hi Chris, I'm new to the Mayo Connect posts and happy to find this information and comments about Prolia. Sounds like you're in good hands with good solutions for healing! My Doc wants me to start Prolia again - after a long absence due to dental implants - and I'm hesitant. Not confident this is a good drug to take after reading all the side effects. I'm active with Sailing and Pilates classes once a week and want to stay active and healthy. Thank you for your posts. Rita

(This comment concerned me: "I don't like the mechanism of action of Prolia. It is an antiresorptive. So it collects old bone and prevents the normal process of remodeling the bone. It holds osteoclasts the last stage of development. In doing so it collects they call it a resevoir of premature osteoclasts that are released on to the bone in a flood of acid when Prolia is discontinued.")

Sorry 1ritat, I meant to reply to you, but may not have dont that correctly!
You don't mention why your doc wants to start Prolia again. Have your T-scores changed? Worsening bone strength and structure is concerning, but there are many paths forward. I would want to know my T-scores (and see a chart comparing them to all past t-scores), my TBS (traebecular bone score), and my bone marker scores, CTX for osteoclast function, and P1NP for osteoblast function, before any drug was discussed. If your doc is not explaining why he wants to put you back on a drug, and testing to determine the best choices for you, that is concerning too.
Good luck to you on this quest for clarity.

Good source to listen to : https://youtu.be/Isxum0ibnJg?si=n77SfZjYqSve9C_o