Good morning, @tmtm4 I’ve taken the past few days to give your post a lot of consideration before replying. Just to clarify, I have a strong dental background but I’m not a dentist so I’m not in a position to offer treatments or tell you to do.
I’d like to help you sort through a few things and narrow your options. I know this is a lot to take in all at once so I think the best way is to break this down into steps and with more than one conversation.
From what you’ve written, you have quite a long history of health, bone and dental concerns. Not having a healthy mouth can cause inflammation and potentially serious health issues in the rest of the body too. So, the goal is to get your mouth healthy again and have a smile return to your face. ☺️

Are you looking to have all your teeth extracted and replaced with dentures? Your current dentist nailed it by saying you’d need to have adhesive (goop) to keep them held in place. However, it is possible and is probably the least expensive option. Generations of grandparents lived that way. The upper would stay in place reasonably well, but the lower denture would have no where to rest solidly, even with adhesive, without a ridge. Do you still have your lower eye teeth? Are they solid? Sometimes those can be used as anchors for a lower denture.

Implants might be the way to go in your case, as I’ll explain further. I know there’s a hesitancy because of the Reclast, osteoporosis and cost. But they might give you a more permanent and fixed dental prosthetic. Implant replacements come in many sizes and options from individual teeth, to full mouth ‘bridges’ (with no palate) to anchors for removable dentures with a palate.
There are different types of implant anchors as well. Mini implants are short, not as long as standard, making them usable in people with diminished jaw bone. They can be used to hold dentures in place. Another option is bone grafting for dental implants if the patient’s bone loss is significant. That’s what’s used in the All on 4 technique.

I think to begin with, talking about bone support in your jaws is a good place to start. Jawbone loss is a common consequence of tooth loss. Physical stimuli such as biting and chewing strengthen the jawbone. Just like weight bearing exercises strengthen our body’s bones. Every time you eat or chew, the biting or chewing force travels through your teeth to the jawbone, stimulating the jawbone to grow and rebuild. After tooth extraction, the jawbone loses its stimuli, causing the jawbone to lose width, height, and volume. After while the upper and lower jaw bones shrink to the point where there is little ridge left on the top for a denture to grip and the lower jaw ridge becomes none existent.

Replacing missing teeth with bridges and dentures won’t solve the problem of bone loss because they don’t transmit the chewing and biting force to the jawbone. Dental implants can prevent jawbone loss because they act like natural teeth roots, and transmit the biting and chewing force directly into the jawbone.

One of the concerns of having dental implants with someone taking bisphosphonates for bone support, such as Reclast, has do with the natural regeneration of bone. Bisphosphonates slow down the deterioration process while reducing bone thinning to a substantial extent.
One concern for discussion is whether or not people who are taking bisphosphonates tend to have a worse prognosis compared to those who are not taking the medication. The reason for this is due to the constant bone renewal process referred to as “bone turnover.” This turnover is only accomplished when the bone has two types of cells – the first type eats up the old bone (osteoclasts) and the second lays new bone in its place (osteoblasts).

Well, because bisphosphonates interfere with the effectiveness of cells that eat up the bone (osteoclasts) it tends to increase bone density. But it isn’t allowing for old bone to be ‘eaten up’ or resorbed. It’s not a natural process of renewal.
Because implants need the bones to heal, the new bone around a newly placed dental implant must be ‘eaten up’ by osteoclasts before new bone can be formed. Because of bisphosphonates, this may be less effective and the area may not heal as well. In some cases, your dentist will recommend a blood test procedure called a serum CTX, which evaluates how your osteoclasts are being affected by Bisphosphonates.

However, you are now on Tymlos, which is another mechanism altogether. It actually allows for both parts of the natural bone building process which, in my opinion, makes you potentially a much better candidate for some implants.

May I ask how your tooth loss journey began? Did you have a history of gum disease/periodontal disease? That is generally how bone support in the mouth begins to fail. How many teeth do you have remaining on each arch that your current dentist feels are solid and could remain?