Prolia treatment for osteoporosis: What is your experience?

Now 67 and have been on Prolia for four years. The only drawback is dental treatment like a tooth extraction, an implant. I did have an extraction at the end of January and the site has not healed properly. My oral surgeon suspects it is the Prolia. I need a small surgery to fix the problem but cannot do it until month five of the injection. (This is not osteonecrosis of the jaw). I also have another issue regarding an old implant (10+years ago). May be able to salvage.
I am sure there must be many women out there on Prolia who have similar dental issues. There should be more research in this area for dentists.
(Its not just Prolia. Similar situation with bisphosphonates and teeth).

Osteonecrosis has been responsible for the ejection/rejection/loosening of previously-well-integrated dental implants as bone recedes around the implant. I'm not saying that that's true in your case, of course, but, having two dental implants and a complicated oral/dental history, the osteonecrosis possibility was one that was foremost in my mind when considering any treatment for osteopenia. As was the risk of longitudinal femur fracturing from bisphosphonates. I'm keeping an eye on diet and exercise and hoping that future DEXA continues to show no change or maybe even some improvement.

Its always at the back of my mind (Prolia) & my dental problems. However, I had lots of dental issues prior to Prolia for many years. I delayed going on meds for seven years from the time I was advised to by the endocrinologist. During that period I just kept losing bone and I did not want a hip fracture. Seems to be a tough decision for so many of us.

I know it's tricky but at least there are more choices than in the past. And maybe there's some safe way to segue among 3 or 4 of them over the long-term without risk. And maybe more people can achieve a reversal of osteoporosis and maintain that without drugs as @windyshores mentioned the doctor she consulted with has? That would be wonderful!

Very very hard to reverse the process after a certain age.

Forteo and Tymlos improve bone quality since they don't affect resorption/turnover. I would assume Evenity does too to an extent though it does affect resorption, to a lesser degree that Prolia or biphosphonates.

@jga7 thanks. That article says 1 in 10,000 on Prolia develop MRONJ. Most cases are at the higher doses used for cancer (10 of 100).

Now I am concerned about continuing with Prolia as I have 4 dental implants that were done about 15+ years ago. If I understand what people say here I am at a higher risk of bone problems around the implants. If this is true then I am scared. So far I have had no problems with my implant. Can anyone clarify the question of implants and higher risk of osteonecrosis?

One in ten thousand develop necrosis on Prolia. These sound like pretty low odds. Glad you are not having problems at this point.

If you do decide to change, make sure you follow Prolia with something else or you might lose all gains and have a higher risk of fracture.

I mentioned the implant issue as it's one that I read about in two studies of anti-resorptive drug-induced osteonecrosis of the jaw and my prosthodontist has seen two cases where osteonecrosis has caused dental implants to fail due to loss of supporting bone. Both patients had taken bisphosphonates for well over a decade. [I have dental implants that are critical to the basic architecture of my bite so it was a big concern I had.] I hasten to add that osteonecrosis is not common, and some people take these drugs for years without developing jaw issues. And science doesn't yet know why some people have a problem and others do not.

The side affects for the bisphosphonates generally include a warning to notify the prescribing physician of any pain or ache or discomfort in the jaw. Maybe one can head off an issue before it develops by changing drugs if experiencing any early side effect like these then. An endocrinologist would likely be able to reassure you about this and/or explore a different drug if appropriate.