Dental implants while on ADT for 4-6 month course

Uh-oh! AI had told me dental implants with Lupron was a problem, one dentist in London told me dental implants with Lupron is not a problem, pretty sure I understood my U.S med oncologist and a "general dentist" to have said the same thing: not a problem. Here, though, it seems most are suggesting otherwise. So,...?!

@joecontheroad
We have a retired dentist as part of this group. He was discouraging somebody to do this a few few weeks ago

@jeffmarc Hi Jeff, think you are talking about heavyphil who posted he is a retired dentist and suggested for me to wait. A few other members posted they had implants done while on ADT with no problems. From what I've read it was definitely advised not to get done if also on bone strengthening drugs with ADT. Like I posted I'm only doing a short course of ADT (Orgovyx) 4-6 months. Seeing the implant dentist this Friday and will run it past him. I'm sure he will check how much bone & density I have and then advise.

@joecontheroad

This is what AI replied about my exact situation:

"With your HDR scheduled for September 15, and you having started Orgovyx only about two weeks ago, I would strongly consider getting the dental implants addressed before September 15, assuming your dentist confirms the graft is ready.

The timing is actually fairly favorable:

Now: about 2 weeks into ADT.
September 15: HDR brachytherapy — roughly 4 weeks away.
Dental graft: already placed ~9 months ago, so it has had substantial time to mature.
ADT: planned for only 4–6 months.
Why I'd lean toward doing the implants now

Orgovyx isn't the major dental concern. The medications that raise the specific concern about jaw healing/osteonecrosis are drugs such as denosumab (Prolia) and bisphosphonates. A short course of ADT by itself doesn't generally create the same concern.

More importantly, you've already had the bone graft sitting for nine months. If your dentist says the graft has integrated properly, there's little obvious advantage to postponing the implants solely because you started ADT.

And I'd much rather have the dental surgery several weeks before your September 15 HDR than have it hanging over you during your prostate cancer treatment.

One thing I'd do before scheduling it

Because you're going to UCLA for HDR, I'd tell both doctors:

"I'm scheduled for two dental implants. I had the bone graft approximately nine months ago, and I'm now one week into a planned 4–6 month course of Orgovyx. My HDR brachytherapy with Dr. Chang is scheduled for September 15. Do you see any reason I should delay the implants?"

I'd also ask the dentist specifically whether the 9-month-old graft is fully integrated and ready for implant placement.

And one important correction from my earlier answer

So, with your actual timeline, I would not put off the implants simply because you've started Orgovyx. If the dentist says the graft is ready, getting them completed well before September 15 is quite reasonable.

If you tell me roughly how soon the dentist can place the implants (e.g., next week, 2 weeks, 3–4 weeks), I can help you think through the healing window before September 15 and whether I'd consider that enough time.

I will talk to dentist and report back

Sounds good. That is exactly the right next step. Given that the bone graft was done about 9 months ago and your HDR is scheduled for September 15, your dentist should be able to tell you whether the graft is fully ready and whether there is any reason to wait.

When you speak with them, I'd specifically mention:

You started Orgovyx about two weeks ago
You're planning only 4–6 months of ADT
Your HDR brachytherapy is September 15

And ask whether they want the implants completed before September 15 and whether they foresee any healing concern from the ADT.

When you report back, we can look at what the dentist says and figure out the timing together"

@copyman
Since ADT isn’t great for the bones, we all know it weakens them, It does throw a question in the mix. If you have enough bone, and they don’t have to put some in and you have to wait a few months for it to grow into existing bone. They can put in the post. The post has to have the bone grow around it before they put on the tooth.

People have said they had it done, An x-ray can tell whether or not the bone is binding around the post. I guess it’s up to the Dentist. We’re all different so it may work great for one person and not so great for another.