Anyone have invisalign while on Forteo or Tymlos?

Posted by soggybones @soggybones, Mar 13 3:46pm

I have a malaclusion that I'm told can be corrected with invisalign treatment for two years. I'm also hoping to start Forteo or Tymlos soon. My orthodontist has never had a patient on either of these drugs so she didn't know if they would slow down or inhibit orthodontic treatment. Just wondering if anyone has experience with this.

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tillymack | @tillymack | Mar 13 9:55pm

Can Forteo or Tymlos cause osteonecrosis of the jaw?

soggybones | @soggybones | Mar 14 6:20am

In reply to @tillymack "Can Forteo or Tymlos cause osteonecrosis of the jaw?" + (show)

@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.

marieaw | @marieaw | Mar 14 8:07am

In reply to @tillymack "Can Forteo or Tymlos cause osteonecrosis of the jaw?" + (show)

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

cat1203 | @cat1203 | Mar 14 10:10am

In reply to @tillymack "Can Forteo or Tymlos cause osteonecrosis of the jaw?" + (show)

@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).

lylii | @lylii | Mar 14 8:19pm

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?

kfhoz | @kfhoz | Mar 15 11:37am

In reply to @cat1203 "@tillymack It is only antiresorptives (bisphosphonates and Prolia) that have that potential side effect, but it..." + (show)

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. ...
"

gently | @gently | Mar 16 10:44am

In reply to @cat1203 "@tillymack It is only antiresorptives (bisphosphonates and Prolia) that have that potential side effect, but it..." + (show)

@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.