Osteoporosis and Dental Work

ipg, hi.
that is my understanding, though infection of the pulp as a reason for the root canal entails risk. The failure of the root canal to heal after apicoectomy might indicate a failure to resolve infection in the tip or avascularity. The risk percentages with these medications is not calculated from individuals who have had invasive dental procedures. I could wish that we had that study.
The incidence of osteonecrosis was not recognized in patients using bisphosphonates until the use of high dose infusion bisphosphonates given to cancer patients.
Periodontitis can cause ONJ and ONJ can occur spontaneously in patients without the use of bisphosphonates, radiation or invasive dental work.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11065535/.
I should add that I have no medical/dental background, and my understanding is limited.

@ipg
You might want a second, third or fourth opinion…🤗

“The O-rings used to secure dentures will need to be replaced regularly as they will start to loosen and will not hold the denture as securely in place. Depending on the amount of wear, the O-rings should be replaced every six months to two years. Although they are not expensive, replacing these fittings usually requires a visit to the dentist.

When used for denture stabilization, a greater number of mini implants are required compared to traditional dental implant systems.

Mini dental implants for upper jaw: Mini dental implant surgical procedure in NYC may not be a good solution for replacing teeth in the upper jaw where bone density tends to be lower.

Mini dental implants to stabilize an upper denture: When mini implants are used to stabilize an upper denture then this process will typically require between 10 and 12 dental implants.

This may mean more traditional dental implants are a more cost-effective solution comparing to dental mini implants.

@osteopatient2026
As of now I was told no dentures , implants or extraction. Down the road maybe a crown or root canal but I do not believe they present a risk for onj

@gently
Thanks for this helpful information. I have my regular six month dentist appointment next week. When I had a crown on an adjacent tooth and the filling on the tooth that is a still bothering me I had a muscle spasm in my cheek. It was excruciating. I had to give it time to calm down. I saw an endodontist before they placed the crown on the adjacent tooth and she said I didn’t need a root canal. That’s why I’m concerned about the pain.

I am on Anastrozole (Aromatase Inhibitor -AI) for breast cancer. So the osteoporosis and muscle spasm could be related to the AI.

Your explanation about osteonecrosis is very helpful. I don’t believe I have osteonecrosis
but it’s annoying that doctors seem clueless. It’s difficult to know where to go from here.

@ipg
I am in a dilemma. Dr with agree to Forteo for 2 years. Then what? No HRT. Dr want Reclast to maintain. I said no due to risk of onj. Then what? Hope something else gets established?

It's been quite a while since I have posted (formerly go walking).......and my, has my life changed.

I completed my two years of TYMLOS with significant gains in my bone density.
TYMLOS was followed by Reclast, to lock in the gains from the TYMLOS. I did lose the extra pounds and muffin top that TYMLOS gifted me, within weeks of going off the treatment.

THEN...on April 30th I had major surgery on my spine and feel human again.
I can now stand up straight, sleep in a bed, wear nice clothes, gained back some height, no longer constipated, can breathe with no strain and overall, feel great.

A very long and risky surgery, but sooo worth it!!

I will have a DEXA Scan in September and hope the Reclast is holding my bones.
I will have testing done in March 2027 to determine if I need another dose of Reclast or go back on TYMLOS or PROLIA. The doctor said if my bones are strong enough, I could only have to do RECLAST every two or three years, if not, I could go back on TYMLOS or Prolia.

I don't think there is any clear cut answer as to what the best choice is as far as preventing osteoporosis or a relapse. I'd say either trust your doctor or your gut. But do SOMETHING!!

@gowalking
Thank you for posting this…I’m on a similar trajectory I hope 9 months Tymlos …
It’s nice to hear solid reports from previous users …I always wonder what happened to so and so…I check in here to see reports of treatment results

I feel the same way...how did so and so make out...what did they decide to do, how did their procedure go?
Sometimes I feel like I get more good information here than in the doctors office.

I do have to say, I'm happy that I went with the TYMLOS, it did make my bones much stronger. Strong enough to tolerate the surgery. Hoping no problems with the RECLAST; so far, so good. I will see my surgeon in about three weeks, that will be a four month check up. I'm hoping all is good. I will get an x-ray prior to my visit. But I feel good and am glad hubby and I made the decision to go forward with it.
I have an appointment with the dentist early in September...fingers crossed!!!!

Just curious if you had any side effects from TYMLOS or issues in the beginning that corrected themselves?

@gowalking
Thank you so much for your update…
Yes I had a little rush feeling, dizzy and some nausea after injection. Usually within an hour but it’s pretty much out of your system in. 5 hours …drink more fluids during the day and a few pretzels (salt to help hold fluids - electrolytes) helped me tremendously (a tip from gently here on the forum) all that pretty much subsided …oh and taking any form of calcium too close to injection time (for me I needed no calcium milk etc one hour before) 😀
My pinp and CTX showed that I was responding as hoped though not a guarantee. I get my next dexa in October. I keep a close watch …my husband went med school so he gives support and his sister I. Doctor…that all helps…he does my injections as well.

I am not yet familiar with all the osteoporosis drugs and actually have chosen BHRT to start, along with diet, exercise etc. to see if that makes any difference. If that doesn't make a difference, I will decide what to do from there.
BUT, a painful tooth is either the decay was close to the nerve/blood supply OR if the decay was substantial and not crowned to hold the tooth together, the tooth could have cracked, as someone here suggested. Root canals are successful only about 30% of the time; most fail.
I recognize that the latest treatment in dentistry is implants but if it were me, I would prefer a bridge (crowning the two adjacent teeth with a false tooth/teeth bridging the two crowns). It does not involve the bone/metal allergy, difficulty keeping it clean etc. I am not a dentist, but have seen many implants fail and have seen beautiful work done with bridges.
As far as onj, my sister was treated with Fosamax over a 3 year period during which she had much dental work done and had no problems; her diet and oral hygiene is perfect though. Just my 2 cents. Blessings - Gracie