Dental work while taking Tymlos?

@gently
First, I commend you from your extensive research. Do you have a medical background? I guess my concerns are based on longevity, MRONJ and side effects. That’s everyone’s concerns. Do you anticipate being on medication for the rest of your life? My friend is considering Reclast- 3 yearly and done. The dental concerns I know will interfere with the Drs. I am now do for a dexi. 2 years ago it was -2.9. I am choosing to wait a little longer just so I can check on my other medical conditions and make sure I have nothing else that I must treat first. Early 2027. Someone wrote in she didn’t want 1 dexi to determine medical treatment. My dr says “just don’t fall”. I’m as careful as I can be . I was in aqua pt yesterday followed by an exercise class. On my weigh to a trainer. Do you use any of the Fortibone products? You have been very helpful. I’ll be 70. Your age??

@ipg, osteoporosis really elicits myriad concerns. I laughed when you didn't mention fracture.
I was certain when I was 50 that I'd have osteoporosis and that I'd eventually take Forteo. Part of the delay for me was that I felt so good. I was 71 when I started Forteo. I wasn't careful, didn't fall and didn't fracture "Don't fall," is excellent advice. Some with osteoporosis fracture and the fall.
I hadn't realized that osteoporosis can cause your jaw to shrink away from the gumline and away from the roots of your teeth. Fortunately for me, it's better to be on Forteo for a while before implant dentistry.
I haven't used Fortibone or Algae Cal; I suspect both are good products.
I worry about too much calcium. I like Solgar products and Jarrow for B12, Folate and K2.
I take magnesium orotate. Because:
Magnesium naturally blocks the formation of hydroxyapatite, the crystal structure that causes calcium to harden in vessel walls.
Magnesium is an essential cofactor for the enzyme alkaline phosphatase, which is required to form new bone crystals. Magnesium integrates into hydroxyapatite crystals to improve bone mechanical strength and flexibility by improving matrix structure.
Regulates Bone Remodeling: It supports the activity of osteoblasts (cells that build bone) and balances parathyroid hormone (PTH) to prevent excessive bone breakdown.
Orotic acid is a mineral transporter that helps magnesium penetrate deep into cell membranes, ensuring high bioavailability.
Orotate also supports the production of ATP (cellular energy), which further aids the metabolic processes involved in bone repair and maintenance.
I've no medical background. You really have to question everything I say.

@ipg, osteoporosis really elicits myriad concerns. I laughed when you didn't mention fracture.
I was certain when I was 50 that I'd have osteoporosis and that I'd eventually take Forteo. Part of the delay for me was that I felt so good. I was 71 when I started Forteo. I wasn't careful, didn't fall and didn't fracture "Don't fall," is excellent advice. Some with osteoporosis fracture and the fall.
I hadn't realized that osteoporosis can cause your jaw to shrink away from the gumline and away from the roots of your teeth. Fortunately for me, it's better to be on Forteo for a while before implant dentistry.
I haven't used Fortibone or Algae Cal; I suspect both are good products.
I worry about too much calcium. I like Solgar products and Jarrow for B12, Folate and K2.
I take magnesium orotate. Because:
Magnesium naturally blocks the formation of hydroxyapatite, the crystal structure that causes calcium to harden in vessel walls.
Magnesium is an essential cofactor for the enzyme alkaline phosphatase, which is required to form new bone crystals. Magnesium integrates into hydroxyapatite crystals to improve bone mechanical strength and flexibility by improving matrix structure.
Regulates Bone Remodeling: It supports the activity of osteoblasts (cells that build bone) and balances parathyroid hormone (PTH) to prevent excessive bone breakdown.
Orotic acid is a mineral transporter that helps magnesium penetrate deep into cell membranes, ensuring high bioavailability.
Orotate also supports the production of ATP (cellular energy), which further aids the metabolic processes involved in bone repair and maintenance.
I've no medical background. You really have to question everything I say.

@ipg yeah they said as soon as you fracture anything, your diagnosis automatically is treated as osteoporosis, no matter what the DXAsays. I hope you never fracture! Yes LOTS of pain—worst ever pain. Worse than childbirth. lol. One of (if not the worst parts) is how LONG it takes to heal. I am still healing (9 weeks since fracture) and I will know my progress in early July at a follow up X-ray with ortho surgeon. Thanks for the well wishes. You take lots of good care of yourself too!!!

@shocknot26
Remind me - how did you fracture? I try to stay away from heavy lifting/ limit it to groceries and a laundry basket. Should I travel, I’ll pack light. I have hearted discs, stenosis and now a meniscus tear that is probably throwing by back out. I wear a back brace sometimes, although pt and drs don’t want to have me rely on it and I live in constant worry… “what if”. This has been an extremely informative and supportive forum. I learn daily

ipg,
I see luck in being trapped between the two very best osteoporosis medications.
Rats given the equivalent of the 20mcg dose in Forteo were treated for 70% of their lifetime without developing bone tumors. https://journals.sagepub.com/doi/pdf/10.1080/01926230490462138
Evista slows down bone resorption. It is said to be equal to alendronate, except that it doesn't seem to protect the hips.
There is a lot of hope for new medications, and it is reasonable to think about buying time. as long as you don't risk fracture meanwhile. It's good that you are examining and questioning everything.
Forteo gives your bloodstream an intense jolt of part of the parathyroid hormone. The half life is about 1 hour but it is gone from your bloodstream within about 4 hours. So these poor rats were inbred to lead to an identical line of rats and they upset trials for 50 years (not just in osteoporosis trials, because they lack the genetic diversity to prevent spontaneous tumors. The tumors didn't happen in response to exposure to teriparatide.
I think bisphosphonates are the only osteoporosis drugs that give you a holiday. With Evenity, Forteo, Tymlos you lose the increase in BMD usually in close to a year. With Prolia you lose more than the increase and most people fracture within the first year.
The trouble with Forteo and Tymlos is that they can stop being effective at around 18 month.
If anything make you wonder, I hope you ask. I'm enjoying our exchange.

@ipg I am (a bit nervously) awaiting my first shipment of Tymlos. It is scheduled to arrive tomorrow. I will do the Tymlos (fingers crossed no unbearable side effects) and see how that helps, and then my endocrinologist shared the plan of something “other than Prolia so as to give the patient a drug holiday in the future.” I like that idea of not being on these meds forever, if that’s ever going to be possible. Right now, I decided on the drug treatment mostly because I am so young. But I debated because I am so young not to as well. It was a tough decision. In addition, once my ortho surgeon tells me my L1 fracture is healed enough (hopefully early July’s appointment) I plan to start pt with a Bone Certified PT (I am lucky enough to have one in my area) to learn all the tricks and tidbits that I can to assimilate into a new normal lifestyle to get many many more years of good health. I just was lucky enough to retire three years ago and I have SO MUCH I want to do! What might I be missing? LOL. I appreciate the discussions here.