Tooth extraction prior to starting Evenity

Hi annmcd12,

The fact that you’re asking seems like you’re not totally comfortable about the timing of the extraction and starting Evenity treatments which is understandable.

I would message my rheumatologist/endocrinologist to discuss treatment contraindications and perhaps get some peace of mind about dental work and the administration of OP drugs.

Evenity worked wonders for me - well tolerated and great results. An extraction was not recommended for me while taking Evenity, but it might be a chicken-egg situation.

Best wishes to you!

Cheers!

I have had 4 Evenity shots to date, then my front tooth broke off at the gum line. My Evenity doctor wants to have the dentist/oral surgeon weigh in on what he/she recommends I do.

(1) One option was to hold off on any Evenity shots one month before and 3-4 months after having a tooth extraction, temporary implant with a capped temporary tooth, to be followed up with a permanent implant once I am finally done with the Evenity shots. My osteoporosis doctor says that would be like starting over on the Evenity treatments and that I would lose all I may have gained with the 4 shots to-date.
(2) Second option is to have a root canal and a temporary (or permanent?) bridge, redoing the crowns on the two adjacent teeth (that I just spent thousands having crowned....).
(3) Third option is to leave my gaping missing front tooth alone, ignore what it looks like, hoping I don't get an infection in what's left of my tooth or in my gum, and finish the remaining 8 Evenity shots.

Does ANYONE have a recommendation or any experience with this situation?

What a place to be caught, between your dentist and your osteoporosis doctor. I know that place well. I am sitting there now. I don't know which I am more afraid of, the possible tooth infection, or the healing time it will take for the jaw bone to heal after extraction. But we have options.

My implants failed twice after osteoporosis drug and dentists are afraid of antibiotics now. My body is wracked with fractures and I'm 82 and nobody understands treating osteoporosis. I can't find anybody to do bone implant instead of cadaver bone. They are afraid

My dental status has me shaking in my boots. I am 77 yrs. old. I need an extraction and some fillings. I think both my doctors are afraid to say yea or na on my next move. I can't get them to agree. Much luck to you.

I am 70-year-old in good health except for osteopenia and osteoporosis in my spine. I have been on Prolia for 5 years (Fosamax made me feel ill) my bone density has improved every year.
A. Two things happened recently, I paused my Prolia injections to have a tooth extracted and have had a titanium implant that is healing well; final appointment to have abutment is March 2025.
B. I had an appointment with my Internist, (annual) my cholesterol which has always been normal has increased to the point that she wants me on a statin. I shared my results with my Rheumatologist last week to explain my concerns with cholesterol and could the results be related to Prolia. She is concerned with the timing of the transplant and started new meds to protect my bone density improvement and suggesting Evenity.
Looking for information from others that have resumed treatment following a titanium implant.

What are the options?

I just had three teeth extracted and had a video conference with my endo this week about which bone meds to take if any. She mentioned that I should not start any bone meds until entirely healed, about three months. I did however have two implants installed, so that may have made a difference.
She made our next Zoom for March just to be sure.

I know it's been a while since you posted but what was the decision. I'm in similar situation. I'm scheduled for 1st of 12 injections of Evenity for July. Now, having a root canal on 2 teeth and possibly extraction if the root canal fails. I've had 2 extractions already but was 2 years ago. I cannot understand what is happening with my teeth. It may be getting to dentures which I've read is really risking ONJ. So frustrated but at 78 yrs old something unexpected frequently.

Well this is a long story. I don't want to take any of the osteoporosis drugs but I also don't want to break my bones. I had a DEXA early this year and it showed improvement in one area and slight loss in another. I've been taking collagen, D, and more recently bioidentical estrogen, which I used to take for a long time and then got talked out of it when we moved south. I also live near an orthopedist who has an Echolight machine so I made an appt with him. His theory is that older women are more or less automatically considered frail, and that the numbers are stacked against them. He asked if I would mind having my ultrasound scan submitted at an age 30 years younger than I am as well as at my actual age. If I'm 56 instead of 86 with the same bones, I am one step into osteopenia. So, do I no longer have osteoporosis? Technically, I don't, but my biggest risk, he says, is being 86. He was thrilled that I was on the estrogen, which he says is the single most important thing. He also says that if someone talks me out of it or I can't take it for some reason, I should take Evenity, which has many of the same benefits and not as many hazards as the other drugs.
Here's how the Echolight ultralight ultrasound works: there are two puzzles with osteoporosis. Half the people who have it and fall don't break their bones, and half the people who don't have it break their bones when they fall. What accounts for the difference? It's the structure of the bone itself, which determines its strength and flexibility. Higher bone density from drugs can actually give you brittle bones that break more easily. You need to see the architecture of the bones, which you can see to some degree with a trabecular scan plus DEXA or on an ultrasound. So a bunch of medical nerds in Italy looked up cases of who breaks bones and then took ultrasounds to find out the bone structure of those who did and didn't break bones. So when you take an ultrasound Echolight, your results are compared to those results and where you fall on the scale tells you to some degree what your risk is. Though if you're over 80, that's not so true anymore. However, though I've broken a femur and cracked a shoulder bone, my bones are actually pretty strong and flexible. The ortho said all the drugs would nothing for building bone for me, not because I can't build bone at my age but because I already have the right structure, I just need to keep it. Which means everything I'm doing plus lots of exercise.
The scan cost $230 and took 20 minutes. The ortho says this will be the standard of care in 5 to 10 years here, as it is now in Europe. I don't know if this disparity is the reason DEXAs aren't terribly accurate, but they're not, and they're expensive and giving us all a big dose of radiation so I'm never having one again.
I just got the actual teeth for my new implants this week and very happy. I have five other implants and haven't had a moment's problem with them. A friend who's 82 and has truly terrible bones got off Fosamax because of side effects and no good effect. She's been on Evenity for a year now and had her first results a couple of weeks ago: 23% improvement in bone density. I will ask her the teeth question.
I feel I got some actual information out of all this and I am going to stop worrying about it now and just keep up the plan. This orthopedist is in Sanford NC, by the way. There are a number of them all over the country, but he happens to have been the doctor who has used it the longest. If at all possible I would recommend seeing one of these specialists and getting the scan plus getting on transdermal bioidentical hormones - I take Biest, quite a low dose since I have a genetic clotting factor (V). Bonus: it makes me feel more like my younger self.