Dental work while taking Tymlos?

UPDATE: I have now gotten personal face to face opinions from two general family dentists, an endodontist, my GP, my endocrinologist, and my gynocologist. Every one of them said the same thing: anabolic medications lile Tymlos and Forteo will NOT affect dental work. However, the biophosphonates (like Prolia and Fosamax) do increase risk of jaw issues.

I hope everyone who is on this thread can see this update; I am still new to this platform and learning. Thank you for all the support and comments. Take care!

Added risk from Tori would only exist if you decided to have them
removed.The risk of MRONJ from bisphosphonates is not high and happens more
in individuals taking bisphosphonates to protect against cancer metastasis
to the bone. And in individuals who have taken the risk medications for a
long time.
I'm on extended Forteo because I like the way it works and because I don't
like the way other medications work. We lose bone because the cells that
breakdown bone have proliferated more than the cells that build bone. The
two mechanisms work together to keep our bones strong for the specific
activities we engage in and to replace bone that has weakened or fissured.
It is a constant process replacing all of our cortical bone over about ten
years, and all of our trabecular bone over two to three years.
Bisphosphonates stop the cells that break down bone from attaching to the
bone that needs to be replaced. In doing so they prevent cells that
remodel the bone from building it back up.
The pth medications, Forteo and Tymlos, increase the cells that build bone
and the cells that break down bone.
I'd rather have the newer, stronger, more vascular bone given the choice.
I watch my bone markers to ascertain that there is a balance between P1NP--
indicating growth, and CTX-- indicating breakdown.
I'm trusting those bone markers, and could be mistaken.
If the balance shifts, I might take a month or two of one of the weaker
bisphosphonates and return to Forteo.
Tymlos may be the stronger medication. I wouldn't object to a year of
Tymlos.
What to do can be difficult to decide. It was easy for me after a lot of
pubmed.
Some of us have too many side effects with Forteo or any of the medications.
Bless your choice.

ipg,
Tymlos is more medication than Forteo. They work in the same mechanism but are different molecularly. We are slightly more likely to have side effects with Tymlos in all the ways that hypercalcemia causes side effects. These effects include hair loss, weight gain and fatigue. Tymlos is 80mgc, Forteo 20mgc. And Tymlos is seen to add slightly more bmd than Forteo.
Both of these medications slow digestion. You might add or increase magnesium in you diet. Magnesium glycinate is though to be the best for digestion.
I use magnesium orotate because of speculation that it adds protection to blood vessels, but doesn't facilitate digestion.
Do you have clues about the cause of your fatigue/ insomnia? Folate/B12/iron. Have you lived alone for long.
MRONJ risk is very small with tori .05% to 1%. High risk numbers are from patients on monthly injection of zoledronate of bisphosphonates after cancer.
Some take raloxifene https://pmc.ncbi.nlm.nih.gov/articles/PMC6336572/ which has it own risks. MRONJ is so rare with raloxifene that it is excluded for the list of risky medications.
If your tori are large or bothersome, you could have them removed. Forteo would speed your recovery.
This process isn't easy, but you are taking all the right steps to make certain that to have the most advantageous results. I'm happy to talk about osteoporosis and happiest if it helps. I don't have a medical background, though keep questioning everything.

ipg,
Tymlos is more medication than Forteo. They work in the same mechanism but are different molecularly. We are slightly more likely to have side effects with Tymlos in all the ways that hypercalcemia causes side effects. These effects include hair loss, weight gain and fatigue. Tymlos is 80mgc, Forteo 20mgc. And Tymlos is seen to add slightly more bmd than Forteo.
Both of these medications slow digestion. You might add or increase magnesium in you diet. Magnesium glycinate is though to be the best for digestion.
I use magnesium orotate because of speculation that it adds protection to blood vessels, but doesn't facilitate digestion.
Do you have clues about the cause of your fatigue/ insomnia? Folate/B12/iron. Have you lived alone for long.
MRONJ risk is very small with tori .05% to 1%. High risk numbers are from patients on monthly injection of zoledronate of bisphosphonates after cancer.
Some take raloxifene https://pmc.ncbi.nlm.nih.gov/articles/PMC6336572/ which has it own risks. MRONJ is so rare with raloxifene that it is excluded for the list of risky medications.
If your tori are large or bothersome, you could have them removed. Forteo would speed your recovery.
This process isn't easy, but you are taking all the right steps to make certain that to have the most advantageous results. I'm happy to talk about osteoporosis and happiest if it helps. I don't have a medical background, though keep questioning everything.

@gently
It really sounds that you are very knowledgeable. According to 2026 guidelines from Dental RX I have exostosis of the mandible, confirmed by an oral surgeon worried that if I start Forteo or Tymlos , make gains, unless I have a plan , I will lose all that I have gained. I am 70. Hrs transdermal patch and evista also have risks. Who is out there who have had “natural “ treatment? May I ask what you used and what your side effects were?

Well, ipg, I do have opinions. Knowledge is a little more elusive.
I knew I'd eventually have osteoporosis, had my first dexa at 50 and became
fascinated with our bones through pubmed. When Forteo was approved it was
a new medical method for dealing with the imbalance between cells that
break down bone and cells that build bone. Instead of stopping the break
down and the build up, Forteo increased both creating a stronger bone.
The method was new, the concept is as old as our bones.
My only experience is with Forteo, so I am very limited, especially
compared to other contributors on Connect. Even knowing I'd have
osteoporosis, I started a little late. I looked everywhere for a doctor
who wasn't insisting on two years of Reclast after Forteo. There wasn't
one. I started Forteo and continued looking for someone to switch to when
the two years were up. Much to my surprise at the two year mark, the
endocrinologist I see said he thought I should continue on Forteo. When I
asked for how long he said, "until your dexa T score is -1. I started my
fourth year in April.

Thank you for all the sharing of information. My last Dexa was -2.5 in the spine so not horrible and no fracture history or falls. However, my dental history is not good with bone loss (not a candidate for implants for that reason) and I'm expecting other extractions down the road. Because I'm so worried about the dental risk, the dr is suggesting Tymlos or Forteo for 2 years instead of Fosamax. But either one has to be followed immediately with a biphosphonate (she likes Reclast). So after 2 years of injections, I would be right back to the risk of jaw necrosis from the biphosphonate. Just doesn't seem prudent given a -2.5 Dexa. I don't want to be foolish either but my primary/gyn weren't all that concerned with a -2.4 for years. I know it's my choice so I'm thankful there's knowledgable people here to help sort it out.