Dentist before treatment in NYC

whereismars, depression really slows us down, but you sound ready for action. Which medications are they recommending? There are two Forteo and Tymlos that don't harm your jawbone. If you are planning Prolia, Reclast or Evenity you'll want to make sure about the bad root canal. The tori shouldn't cause any trouble unless you want them removed.
You should feel really good because most of us are lower than -2.7. Tamoxifen has been protecting your bones for the last ten years. And there are good osteoporosis medications.
Welcome to connect. You should hang out with us while you decide which medication you want to take.

@gently thanks so much for responding and your encouraging words. All I have is the diagnosis so far. My internist ordered additional bloodwork and instructed me to get clearance from my dentist so we can start some kind of treatment (he hasn’t mentioned which medication yet). I don’t have a dentist so I hoped for advice on how to find the right dentist, should I rush to get dental insurance because what I have now is limited (NY Medicaid). He also instructed me to make an appt with an endocrinologist that he recommended but the soonest appt he had was Aug 18th. Four months seems like too long time to wait, or is this normal? I am not sure how fast I should be moving, but it seems obvious that the clock is ticking. I’m scared to go on bisohosphonates. Are working out and nutrition and collagen and supplements really not enough to reverse this to a safe level? Or is it too late for that? I don’t know a soul with this so forgive all these questions!

whereismars,
if you get on the cancellation list at the endocrinologist, you'll probably get in sooner. The normal wait for an endocrinologist is about four months. You might send a note to your internal medicine person asking for an alternate referral because of the wait time. But you are using this time wisely learning about osteoporosis.
Otherwise, the first step is the dentist. You start with a general dentist. It's good to get your teeth cleaned and have a general assessment of your teeth. While you can have fillings and cleanings on these medications, you'll want to know if there are any root canals or teeth that need to be removed. Any procedure that enters the jawbone puts you at risk for death of the bone with the bisphosphonates, Prolia and Evenity. The way those drugs work is by reducing the process where cells remove old bone. So jawbone damaged by procedures can't repair itself very well and decays. Prolia is very strong and provides the greatest risk. The bisphosphonates are not as strong and usually it takes many years to incur this risk, except for Reclast--the strongest of the bisphosphonated.A person is usually only prescribed Evenity for a year so the risk is reduced.
Forteo and Tymlos work in a different way. They increase the cells that remove old bone and the cells that replace that bone. So there isn't a risk for osteonecrosis with these two drugs. And they are given as part of a cure.
Endocrinologist who study bone are encouraging the use of these medications before the use of drugs that reduce bone turnover.
Your case might be complicated by the prior cancer. When Forteo was approved by the FDA a cautionary black box was mandated for the possibility of the drug causing bone cancer. That warning was removed after decades of use is thought to prove that there is no risk, but the older idea still influences some physicians.
I don't carry dental insurance because coverage is so poor that I'd end up paying more in premiums than receiving in benefits. You may find a great policy. It is worth looking into.
Women lose the most bone in the first 5 to 7 years after menopause, then the the loss slows. Opinions vary over whether you can regain sufficient lost bone with nutrition to prevent fracture. I suspect that it isn't possible, even with replacement hormone. Most of us on the medications are always working out the collagen and other supplements and exercise because we are afraid of fracture.
While it may be too late because of age, it isn't too late by neglect. It really is the inevitable estrogen loss.
It is worth looking at the information on the "natural" remedies on this site.
About the ticking clock-- some people have fragility fractures while still in osteopenia. Doctors like to tell us that more fractures happen with osteopenia then with osteoporosis. On the other hand, I was in your situation at your age and didn't lose more bone density over the next nine years without medication, without fracture.
We really like questions.

Dental procedures while taking osteoporosis medication statement issued - got notice via International Osteoporosis Foundation (IOF):

Healthy Bones Australia has published a new statement for doctors and dentists, clarifying approaches to dental procedures while taking osteoporosis medication. The statement has been developed following broad collaboration, and is endorsed by the Australian and New Zealand Bone and Mineral Society, the Australian Dental Association, Endocrine Society of Australia and the Australian Rheumatology Association.

Getting all those different types of professions to agree on a published statement is quite and achievement! This statement does not definitively answer everything for me but it is a piece of the puzzle. Key take-aways for me were:

- Patients already taking osteoporosis medication should not be advised to cease osteoporosis medication in preparation for an invasive dental procedure as this places bone health at risk.
- For patients about to commence osteoporosis treatment it is recommended to complete SERIOUS dental procedures before commencing osteoporosis medication.
- When a patient is considered ‘high risk’ AND requires an advanced dental procedure then it is recommended they are referred to a dental specialist with experience in this area discuss their medication management with an osteoporosis specialist.
https://healthybonesaustralia.org.au/news/new-statement-to-clarify-approach-to-dental-procedures-while-taking-osteoporosis-medication/

I had a tooth pulled mid April in preparation for some orthodontics, and now my insurance says my 24 months is up regarding the Tymlos I have been taking the past 2 years. So I either have no medication while this extraction heals, or go on Reclast? Yikes. Terrible timing for them to tell me they won't pay for Tymlos. I just need one more month, but it costs $3000 without insurance.

@susyt would you feel comfortable asking your doctor if they have any sample pens you could have because of your dental situation?

I think if she had one she would have offered it. Good idea, though, thanks.