Dental work while on Reclast?

Posted by sebutler @sebutler, Feb 6, 2025

Has anyone had dental work done while on Reclast? Any problems, particularly if the dental work involved an extraction or an implant? A published survey found that cases of jaw necrosis occurred two or more years after beginning Reclast, but six years or more for patients on Fosamax.

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

Profile picture for kar50 @kar50

I am looking for the comment regarding Invisalign while on Reclast. I saw it earlier but my search isn't bringing it up.
This thread on dental work while on osteoporosis meds is really important, and my dentist thinks there are no concerns. I'm on my last 5 months of Forteo, and am researching and mentally preparing to start Reclast as per my endo's recommendation.
In the meantime I've had dental work done (crowns) with no issues, but at age 75 my lower teeth are becoming noticeably more crooked. They were slightly crooked most of my life, and my bite is becoming so off that I'm experiencing chipping. I've consulted with two orthodontists for a consult on both Invisalign and standard braces. I really wish I didn't need to do this at age 75 (!) but I also want to have good teeth as long as possible.
I would love to hear from anyone who has braces/invisilign while on osteoporosis meds and their experience.
Thanks.

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@kar50
I have invisalign while on Prolia and I've had no issues except that my teeth seem to be moving more slowly. I have to wear each tray longer than they say. I assume that is due to the bisphosphonates but don't know for sure. I am switching to Reclast next month. My bottom teeth were shifting forward so much that they were really crooked and overlapping which made it hard to keep them clean. They felt that I would be able to reduce the potential of dental problems w/those teeth if we could fix the crowding.

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Profile picture for kar50 @kar50

@gowalking

Thank you for your encouragement! I've decided that if I do go ahead with the teeth straightening, I'll opt for regular braces rather than Invisiligns. I don't think I'm a good candidate for 20-22 hours a day. In my retirement I've come to enjoy lingering over tea in the morning and light snacking anytime - haha!
I'm so glad it worked well for you and I think a nice smile smile will be worth it!

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@kar50
I did the invisalign and am so glad I did. I wear mine primarily at night which also makes the whole process take longer, but my orthodontis is so kind and patient, and he is fine with it.

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Profile picture for gowalking @gowalking

I just had a dental extraction and implant both done on the same day. This past Friday.
I will finish TYMLOS this Thursday. How long do I wait for a Reclast infusion and will the already completed dental work matter since it is already done?
What is the longest you can wait for the first infusion....and....do you take vitamin D and calcium supplements while on Reclast?

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@gowalking
If I were you, I would definitely contact the doctor who is treating your osteoporosis (the one who will order the reclast infusion) and let him know the dates & details of your dental work and the date you will finish Tymlos (a reminder because details sometimes slip thru the cracks), and ash for his/her input on when you can safely get the Reclast.

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Profile picture for ljoh @ljoh

I have recently inquired about having some orthodontic work done and was told that studies show very poor result for patients who had reclast injections, and was discouraged from pursuing this. I would encourage you to provide your health history to any oral surgeon you are dealing with and make sure that they are aware and informed about reclast before having any dental work.

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@ljoh
When you say poor results, is it that the teeth do not move well? Or if it is other problems, do you mind sharing here what those are? I have invisalign and will be switching from prolia to reclast so I'd love to know. Thank you.

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Profile picture for mmkrsk @mmkrsk

@gowalking
If I were you, I would definitely contact the doctor who is treating your osteoporosis (the one who will order the reclast infusion) and let him know the dates & details of your dental work and the date you will finish Tymlos (a reminder because details sometimes slip thru the cracks), and ash for his/her input on when you can safely get the Reclast.

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@mmkrsk

I did ask the doctor and she said get the Reclast two to four weeks after stopping TYMLOS. Reclast will freeze the gains from TYMLOS so you don't want to wait and begin losing the gains. The dentist said since the extraction and implant were done a few weeks before the Reclast, it should be good. I went back to the dentist at two weeks and four weeks for post procedure check ups and all is good.

I will be having back surgery on Thursday, April 30, 2026 and the dentist has recommended keeping the Invisaligns in during surgery to protect the implant, I have left them in during two prior surgeries and am hoping I can this time also.

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Profile picture for mmkrsk @mmkrsk

@kar50
I have invisalign while on Prolia and I've had no issues except that my teeth seem to be moving more slowly. I have to wear each tray longer than they say. I assume that is due to the bisphosphonates but don't know for sure. I am switching to Reclast next month. My bottom teeth were shifting forward so much that they were really crooked and overlapping which made it hard to keep them clean. They felt that I would be able to reduce the potential of dental problems w/those teeth if we could fix the crowding.

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@mmkrsk
My bottom teeth are also the main problem, which led to 2 cracked teeth and the decision to begin orthodontic treatment.
I see that you mainly wear your Invisalign at night. I've opted for traditional braces because I didn't want the interruptions during the day of eating, drinking tea, etc.
Best of luck and happy that you're protocol is just right for you.

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