1. < Osteoporosis & Bone Health

How soon to resume Prolia after tooth extraction

Posted by pianogirl1943 @pianogirl1943, Jan 7 9:09am

I had my last Prolia shot in July 2024 and am due for my next now in Jan. '25. I just had tooth extractions last week and may need another on 1/27 (praying doc can save the tooth). How long should I wait to resume Prolia? Couldn't get an answer from my very uncooperative rheumatologist. I'm 81 and have osteoporosis for 10 years, and am scared to death of osteonecrosis.

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gently | @gently | Jan 7 2:16pm

pianogirl1943, four to six weeks is the usual recommendation, or when the wound has healed. I add my prayers for saving the tooth and no osteonecrosis.

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pianogirl1943 | @pianogirl1943 | Jan 7 2:48pm
In reply to @gently "pianogirl1943, four to six weeks is the usual recommendation, or when the wound has healed. I..." + (show)
@gently

pianogirl1943, four to six weeks is the usual recommendation, or when the wound has healed. I add my prayers for saving the tooth and no osteonecrosis.

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Gently...
Thank you so much! Do you know this from experience or literature? And thank you for your prayers.

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gently | @gently | Jan 7 6:13pm

Literature. The risk is said to be rare " ONJ (risk 2.3%)" with extraction.
"Clinicians should be aware of the length of time a patient has been on an antiresorptive, particularly, if more than 4 years. The number of extractions performed at one time is best limited and extractions are best performed at 6 to 7 months after the last injection of denosumab. Sockets should be allowed to heal before recommencing denosumab.22,23 To avoid the risk of vertebral fracture, denosumab, or another antiresorptive should be recommenced by seven and half or 8 months after the last injection.7" https://www.sciencedirect.com/science/article/pii/S8756328223000558
Will you have bone implants. How long have you been on Prolia. Is your experience with Prolia free of side effects.

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1 reply
pianogirl1943 | @pianogirl1943 | Jan 8 7:16am
In reply to @gently "Literature. The risk is said to be rare " ONJ (risk 2.3%)" with extraction. "Clinicians should..." + (show)
@gently

Literature. The risk is said to be rare " ONJ (risk 2.3%)" with extraction.
"Clinicians should be aware of the length of time a patient has been on an antiresorptive, particularly, if more than 4 years. The number of extractions performed at one time is best limited and extractions are best performed at 6 to 7 months after the last injection of denosumab. Sockets should be allowed to heal before recommencing denosumab.22,23 To avoid the risk of vertebral fracture, denosumab, or another antiresorptive should be recommenced by seven and half or 8 months after the last injection.7" https://www.sciencedirect.com/science/article/pii/S8756328223000558
Will you have bone implants. How long have you been on Prolia. Is your experience with Prolia free of side effects.

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I can't thank you enough for this, Gently. I've forwarded it to my periodontist. I have not had noticeable side effects from Prolia.

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