Unable to assert myself at 73...I have Severe Osteoporosis

Posted by lane73 @lane73, Dec 26, 2025

I am on Prolia for Severe Osteoporosis but needed tooth extraction traction which can cause ONJ so together with that problem I also have EXTREME DENTAL PHOBIA so I had an appointment for a Consultation with a brusque and no nonsense Dentist albeit extremely good at his job he gave me an appointment for the extraction and told me I would lose all my teeth due to Gum disease but I need to have my teeth cleaned every 3 months and to go downstairs in the building nd get them done but I refused as I am too nervous...but now I am trapped ...I need the extraction and Dentists are rare and hard to come by..I am 74 and still as meek as I was as a teenager..Dentists are really expensive and hard to come by and this Guy knew more about Prolia and the dangers involved than my Doctor he told me ONJ was not rare as my Doc told me she knew Zero about it but im back on the 8th January for the EXTRACTION and then the cleaning which terrifies me as it takes an hour....SORRY FOR GOING ON BUT IM SO WORRIED

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

Lori, Volunteer Mentor | @loribmt | Dec 28, 2025

In reply to @lane73 "@gravity3 the Dentists did resemble Battle Star Gallactica...not a warm atmosphere but I am living in..." + (show)

@lane73 we need to have a 😂 emoji!!!

lane73 | @lane73 | Dec 29, 2025

In reply to @loribmt "@laura1970. I think it’s really a good idea having an appointment to discuss your medications and..." + (show)

@loribmt

@laura1970. I think it’s really a good idea having an appointment to discuss your medications and the upcoming dental extraction. Hopefully your dentist can reassure you that the potential for developing ONJ after the extraction is very rare. There are precautions taken prior, during and following the extraction to minimize the potential for infection.

The first priority post extraction is to keep the blood clot intact. I mentioned the preventive steps for that in a previous reply. ONJ can develop if the bone is openly exposed after the extraction with no blood clot or tissue covering the bone. In that situation, blood can’t reach the exposed area causing bone cells to die.

That’s why it’s crucial to make sure the blood clot isn’t disturbed once it forms. You can develop what’s referred to as a dry socket. That’s infrequent but if it occurs, it tends to be a lower molar area. The first indication of a dry socket being the extraction site might feel better for a day or two and then become painful again. You may have an unpleasant taste and/or odor.

If that happens call the dentist to be treated appropriately with the next steps…which generally are to rinse the site, pack the opening with a medicated iodoform gauze or other medicament to protect the bone while healing or if needed there may be a prescription for antibiotics.
I’m not sure where you’re getting the information but meds are effective in treating ONJ. There are 4 classifications of ONJ each with their specifics for treatment.

The statistical risk for developing ONJ for a non-cancer patient, as of August 2025 is 0.7%. That’s very low and should be pretty reassuring for you!

Here’s the entire article:
From MDPI with the study from the Journal of Clinical Medicine
Prevalence of Osteonecrosis of the Jaw Following Tooth Extraction in Patients with Osteoporosis: A Systematic Review and Meta-Analysis
https://www.mdpi.com/2077-0383/14/17/5988
We have quite a few members in Connect who are taking meds for osteoporosis with similar concerns for dental care. Here are a few links with their discussions you may want to check out.
Dental extraction while taking Prolia,
https://connect.mayoclinic.org/discussion/dental-extraction-while-taking-prolia/
~~~~~~
10 years on Prolia and requiring extractions lower jaw
https://connect.mayoclinic.org/discussion/10-years-on-prolia-and-requiring-extractions-lower-jaw/
~~~~~

Here is the search:
https://connect.mayoclinic.org/search/
Please let me know what you find out with your discussion. Have a list of questions ready for your doctor. I really feel that you’ll have a better understanding that the risk is low for ONJ. The greater risk is not having a healthy mouth, gum tissue and bones. Will you also ask about possibly having an anti-anxiety med pre-treatment?

Jump to this post

@loribmt hi Lori firstly I have advanced Gum Disease which is another of my worries...I joined a FB support Group for people on Prolia....did I mention the Dentist gave me a Prescription for Antibiotics to start 4 days prior to my visit....I was on Forteo for 2 years..I discovered I had Osteoporosis when I walked to Bathroom and then found I couldn't move...I had 2 Fractures an L3 and T12 and my Doc was treating me for muscle strain for 6 weeks before sending me for an XRAY ..I was diagnosed then with Spontaneous Fractures....I have had same Doc for 20 years and I asked her on my last visit if she had treated ONJ and she said no...I thank God I was born with intellect otherwise I would be in a lot more trouble than I am..
As much as I dislike this Dentist's attitude he is well versed on Prolia he even asked about my Dexa and found it hard to believe I had no Osteoporosis Consultant which I assumed was normal..
I get my injection from the Nurse in the GP practice....I am on Prolia for 1 year ...I have had 2 shots and am into the beginning of my 6th month of 2nd shot....the Dentist is my biggest asset in this as my GP is clueless....thanks Lori for the info it is extremely helpful..in Ireland Osteoporosis maybe common but people don't question medication most avoid it..😊

lane73 | @lane73 | Dec 29, 2025

Well Lori I am more armed to the gums but this Dentist is knowledgeable which is a major plus but sometimes you feel people do not hear you...I spent 5 minutes gushing about my Dental Phobia and Anxiety and 2 minutes later he asked me to go downstairs for an hour of cleaning...I had to refuse as I would need time to brace myself for that onslaught....when they start I start gagging ...pain does not bother me too much I can take it...I have just replied to you as regards your last post..you are most helpful and I do appreciate it...😊

lane73 | @lane73 | Dec 29, 2025

In reply to @stanfojc "I feel for you. Maybe you can take headphones and some relaxing music of your choice..." + (show)

@stanfojc I would most probably beat the Dentist around the room out of Panic i feel I am better unarmed...but thanks for your kindness in replying to my situation 😊

gargoy | @gargoy | Dec 29, 2025

Do you need to get a second opinion?l. Medicare will cover maybe 80% of the cost of a second opinion, but I always call them before I go through with any medical appts. to make sure whatever I'm doing is covered.

laura1970 | @laura1970 | Dec 30, 2025

In reply to @loribmt "@laura1970. I think it’s really a good idea having an appointment to discuss your medications and..." + (show)

@loribmt

The statistical risk for developing ONJ for a non-cancer patient, as of August 2025 is 0.7%. That’s very low and should be pretty reassuring for you!

Jump to this post

@loribmt thanks so much for, you’ve eased my mind

lane73 | @lane73 | Dec 30, 2025

In reply to @gargoy "Do you need to get a second opinion?l. Medicare will cover maybe 80% of the cost..." + (show)

@gargoy Hi I am in Ireland and we do not have Medicare...all Dentists are private..I had a Consultation and it would have been about 200$...God knows what an extraction will cost..the " God Knows" is just our way of saying it will be expensive....but thanks for your kind reply....😊

vagirl57 | @vagirl57 | Dec 31, 2025

My dentist said that dentists think osteonecrosis is under reported by doctors. In my small circle, I know 2 people on Prolia who got osteonecrosis.

lane73 | @lane73 | Dec 31, 2025

In reply to @vagirl57 "My dentist said that dentists think osteonecrosis is under reported by doctors. In my small circle,..." + (show)

@vagirl57 my Doctor told me in her 20 years of practice she had never seen it yet when I told my Dentist that she said it was rare occurrence he said it was not..I have to inform my GP of what I learn on the Prolia Website...my Doc is abysmal....thankfully I am aware ...

56huxley | @sjs1 | Jan 1 12:29am

Lane73- Sorry you are going through this.
Have you discussed using an
Laser instead of extraction?
The most well-known system is LANAP (Laser Assisted New Attachment Procedure), but many dentists use similar lasers under different names.
Typical process:
1. Laser disinfects the pocket
2. Gentle ultrasonic cleaning
3. Laser again to seal tissue
Often done with local anesthetic only.
Why it’s attractive for fearful patients
• Less bleeding
• Often less post-procedure pain
• Usually no cutting or stitches
• Appointments may be shorter or broken up
For someone terrified of dental work, this may be an option. Not paid for ny insurance. Check if there is dental school affiliated with a hospital near you for reduced costs.
Why laser therapy is often chosen because of Prolia
Laser periodontal therapy:
• Does not cut bone
• Reduces infection
• May help avoid extraction
• Is often considered safer than surgery in Prolia patients
Many periodontists specifically use conservative approaches because of Prolia.
The most important thing to understands
This is why preserving even a few natural teeth is so valuable:
Even 2–4 retained teeth can dramatically improve stability, chewing, and future options.
That’s why:
• Periodontists fight hard to save teeth
• Laser therapy, maintenance, and conservative care matter
• Extractions should be a last resort, not a starting plan. Cleanings must be frequent usually done every three months if you want to fight to save your teeth. Nitrous oxide (“laughing gas”)
• Very commonly used for anxious adults
• Wears off quickly
• You stay awake and responsive
• Does not interact with Prolia
• Can be used for cleanings, deep cleanings, and laser therapy. Otherwise, oral medicines to alleviate anxiety can also work as long as you have a ride home. Examples: low-dose benzodiazepine (e.g., lorazepam).