Anyone have invisalign while on Forteo or Tymlos?

Can Forteo or Tymlos cause osteonecrosis of the jaw?

@tillymack According to my doctor there have been no documented cases of osteonecrosis of the jaw associated with Forteo or Tymlos. In fact, some physicians use those drugs to treat it.

@tillymack
I am on Forteo and my endocrinologist said it does not cause osteonecrosis of the jaw.

@tillymack It is only antiresorptives (bisphosphonates and Prolia) that have that potential side effect, but it is uncommon. I can't remember the source of this information now, unfortunately, but my understanding is when it does happen, it's most often associated with the higher doses a cancer patient would receive while receiving Reclast (which has another brand name for cancer treatment that I don't recall, but zoledronic acid).

Maybe so, but it happened spontaneously in a friend of my Mom. I would never take those drugs. (bisphosphonates/Prolia)

Tymlos and Forteo shouldn't, but who really knows? Is correcting the malocclusion right now critical?

Here is a 2025 paper from Finland that discusses medicine related osteonecrosis of the jaw (MRONJ) caused by antiresorptive (AR) drugs and may be the source that @cat1203 is trying to recall. It confirms what she said about it is cancer patients on higher doses who are at much greater risk. The paper also discusses other factors, especially corticosteroids, that can raise the risk, so the details are important.

Incidence of medication-related osteonecrosis of the jaw and associated antiresorptive drugs in adult Finnish population:
https://www.nature.com/articles/s41598-025-02225-2
Excerpt: " ...Additionally, the patients diagnosed with cancer receiving low-dose antiresorptives (ARs) had almost 100-fold risk of developing MRONJ compared to those diagnosed with only osteoporosis. ...
"

@cat1203 Zometa, but Evenity also has a caution, less likely because it's taken short term. But then there are the spontaneous as lylii mentions.
The jaw problem, generally, follows the type of dental work that introduces normal oral bacteria into the bone. Drugs that don't remodel bone create bone that doesn't repair itself. The bone from afore mentioned drugs develop bone that is less vascular a distinct disadvantage when trying to get antibiotics on site.
Forteo, with the immediate action of getting rid of damaged bone, is often used to treat osteonecrosis.

Hi @soggybones
I am faced with a similar decision and am curious if you have an update.

What have you learned? Have you made decisions about starting invisiline and/or osteoporosis?

@jlharsh

My endocrinologist told me that I would not qualify for an anabolic because my BMD isn't low enough. I do have severely degraded TBS, but she said that doesn't matter to the insurance company. She suggested HRT, but I'm a high risk for breast cancer and because I suffer bad hot flashes she said I would not be able to tolerate Evista. That leaves bisphosphonates as my only option and I don't want to take them with my extensive dental work. Another person on here suggested Duavee so I'm going to look into that. In the meantime I am only changing my diet and upping my strength training. I'll go ahead with the Invisalign and get another Dexa once treatment is complete. So far, I haven't found any answers regarding anabolic treatment and orthodontic treatment. Wish I could offer you more insight!

Hi there, yes I have seen an orthodontist about getting Invisalign while on Tymlos, and they do treat people on these drugs (anabolics) and also on bisphosphonates but they say it just takes longer. In my case they could not proceed because I have TMJ and xrays show I am in the midst of remodeling my jaw so they want to wait until this has done before doing the Invisalign. If this is any help to you..