Tooth extraction while on Evenity

This is exactly why I won't take any of these anti-resorptive drugs for osteoporosis. They all can cause necrosis of the jaw. While it is rare, it can happen. While necrosis of the jaw is treatable, according to my dentist, I have read some horror stories about what people have gone through as a result of taking these drugs and then needing dental extractions, only to end up with necrosis of the jaw.

On a positive note, you have only been taking it for three months, and it is a rare side effect. I would go with your periodontist's decision about how long to wait before extracting the tooth, and even then get a second opinion. As long as you are being carefully checked regularly by your dentist/periodontist you should be ok.

I am also on Evenity. I have had three shots to date. Of course, I had a tooth flairup and had to have it extracted. It is best to have your extraction as close to your next Evenity injection. Drug holiday is not recommended like it use to be. There is a good journal article to read Journal of Oral and Maxillofacial Surgery. American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaws --2022 Update.
I hope this helps. I don't think you should consider an implant but consult with your oral surgeon as opposed to the Periodontist.

Thank you for this information. What is the reason to not recommend an implant?

There seems to be a lot of uncertainty around this because the decision can depend on the individual’s osteoporosis treatment, dental procedure, and overall risk factors. I’d be cautious about stopping Evenity or changing the timing of injections without the prescribing specialist being involved, particularly when the medication is being used for fracture prevention.

It also sounds sensible to have the periodontist or oral surgeon coordinate with the doctor managing the Evenity rather than making the dental decision in isolation. The extraction itself and the later implant are separate decisions, so I would want the clinicians to assess healing before committing to the implant stage.

For anyone in the Sydney area looking for a dentist to discuss the dental side of a complex medical history, Shire Doctors and Dentists in Caringbah may be a local practice to keep in mind, but the treating dentist and osteoporosis specialist should still make the treatment decisions together.

Hopefully your periodontist gets clear guidance from the relevant specialist before the extraction. The 2022 AAOMS position paper mentioned above is also worth discussing with your clinicians rather than relying only on experiences from other patients.