Stopped Prolia due to upcoming dental surgery

ariespumpkin, when was your last Prolia injection?
You may know about Prolia rebound, but in case you don't you might want to know that it is a hazardous to even be late for the six month injection. Prolia stops the development of cells that breakdown bone. It stops them in the very last stage of development. It doesn't cause these cells to die, but collects them in what they call reservoirs of cells that sometimes combine to become super bone eating cells. But when you stop Prolia all these cells rapidly finish developing and are released. The effect on your bones is devastation. Patients experience multiple fractures called cascade fractures.
Prolia is the only medication that will leave you worse off than if you'd never taken it unless you follow it with a strong antiresorptive. Reclast is the strongest and even Reclast is sometimes not adequate to ward off those cells. The bisphosphonates including reclast which also carries a risk for osteonecrosis.
I've come to the thinking that the best solution in this situation is to add Forteo to Prolia. Together they offer more bone acquisition than the drugs alone. And Forteo is prescribed for the difficult to remedy bone osteonecrosis.
Your oral surgeon may be able to order Forteo for you, though I've spoken to several lately who are unaware of the medication.
Two important consideration are how long you have been on Prolia and when was your last injection.
I'd ask the oral surgeon about Forteo. They may understand your situation. But also try to get into an endocrinology office and general practitioners office whichever is soonest.

@gently I appreciate this information. My last injection was in June 2025; I was scheduled for my next injection on the 5th of January 2026, but cancelled the appointment due to the upcoming surgery. I will contact my dentist regarding my issue ASAP. Appreciate your response.

My friends, thus the importance of dental health in osteoporosis treatment. Please keep up your regular dental cleaning and screening. This might give us the information we need early enough to avert the conflict between the dental procedures and the osteoporosis treatments.
@ariespumpkin, this post is not directed toward you. But I mean it to be a reminder to all of us.

I took Prolia for 1 year and after a bad rash and lack and. More I switched to Alendronate (Fosamax) for 9 mos. I decided to quit all meds which is scary since I’m 72 and -4.2 hip dexa scan. I cannot tolerate the side effects of Alendronate. I get IBS so I’m going to just live with this. I e known people who are on the meds and have broken their bones despite taking meds. I feel like the drs are pushing these meds & the drug companies are profiting , it that’s just my opinion. I exercise daily and will do so till I can’t.

I totally agree with you. Everytime there's a post on "How to increase bone density" there's always a sales pitch at the end. I will be 74 in March; walk 2 miles everyday; have numerous stairs in my house and I have more energy than most people 10 years younger than me. I eat healthy most days; love veggies, eat cottage cheese and yogurt.
I have never broken any bones yet; and hope to continue on that path. Appreciate your input. Good luck to you and wishing you many more years of health and happiness.

@ariespumpkin Wow! We have similar thoughts and life styles. Everything you said is similar to my lifestyle as far as stairs, walking and eating dairy and vegggies. It made me happy to see I am not the only one who feels this way. Have a great day and continue doing what youre doing.

I am 72 yo and was diagnosed with op in my late 50s. I had one injection of Prolia with side effects (large body rash lasting 8 months, pins/needles bilaterally from knees to toes when not moving, feeling of flat affect, unable to complete my regular runs due to SOB). I did not take any other meds due to side effects. I do a slow 4 mile jog and bowflex strength pulley weights 5x/wk and on veggie diet (probably should increase my protein). My femoral neck is -4. I recently started taking bone strengthening supplements and increasing by D (which was low). I have not suffered any fxs and hope to stay safe. Wishing you all the best.

The rebound window is 2 to 10 months after your last dose wears off. So 8 to 16 months after your last dose. When is your dental surgery?

You should be back on Prolia or transitioned to a bisphosphonate like Fosamax or Reclast in February to avoid the rebound. Reach out to your PCP to either prescribe Prolia again or better yet, refer you to an endocrinologist.

This is something to take seriously. See this post for reference: https://connect.mayoclinic.org/comment/1489422/

@ariespumpkin, It looks like your timing is good.
"Case reports then appeared of new, often multiple, vertebral fractures that developed in patients within a few months of stopping denosumab — termed “rebound-associated” fractures. "
https://pmc.ncbi.nlm.nih.gov/articles/PMC5915244/
If your plan is to stop Prolia, you would want to consider a bisphosphonate. Reclast is usual after Prolia, but there can be fierce side effects, life changing for some. You may be one of the many for whom Reclast isn't much of a problem. Some people have sufficient protection from alendronate (Fosamax).
Best wishes for your surgery and after.