Tooth extraction prior to starting Evenity

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.

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!