I was told to get all my dental work done because my bone scan Showed -3.5 and osteoporosis. The pandemic held up my dental work for implants and in extractions.
It is two years later and another bone scan showed my numbers were even worse and now that my hip femur was -3.0 a nd spine -3.7. Apparently I have periodontal disease bone loss in my mouth and will need more implants in the years ahead.
They now say I may need to have my bottom four front teeth removed and I am only 62. One doctor is recommending I start on reclast. I have taken no medication that’s far because it was on hold for dental work.
What would you take if you were me and know that you will have more dental work in the future on a constant basis?
This is completely upset me and I don’t know what to do.
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AimeeRU4me
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A few questions. Were you properly assessed for "secondary causes of osteoporosis"? And were you given any advice about nutrition and exercise to help maintain your bone density, if not actually improve it, while you waited for the necessary dental work?
I will give you a couple of links to check to get you started.
If you have no fractures I do recommend that you do what you can to maintain your bone density without medication and get the dental work done. If you have experienced fragility fractures then you should still do what you can for your teeth, but your decision about starting medication sooner may be different.
You may also be interested to know that Vitamin K2 helps dental health. You can google it, and many of the sites that come up are dental clinics! This is not the same as Vitamin K1 which we know for its blood-clotting ability. Vitamin K2's job is to direct calcium into the bones, and unfortunately is often lacking in a standard Western diet.
Thank you so much for taking the time to write. I so appreciate all the info. I have seen an endocrinologist and had about four tests to make sure it is not another condition. I have been taking AlgaeCal for 2 years, which has not worked for me.One problem is that I have chronic fatigue/ME, so I have been very sedentary for the last three years after I lost my job. I have not been able to do any weight-bearing exercises.
I hate that you are going through this. The good news is that someone informed you that you should get the dental work done prior to going on bisphosphonates. As HeronNS mentioned, you need to make sure that your doctor has tested you for other possible causes of bone loss. Osteo-meds will not stop bones loss if you have parathyroid gland issues. I recommend you go to betterbones.com/testing/wha... and print the list of tests and review the list with your doctor.
Additionally, you might want to look at Marodyne LiV (low intensity vibration) therapy or OsteoStrong.me. Note, I haven't tried either of these. The thing that "sold" me on OsteoStrong is a video clip on their website about Thyroid issues (I have hypothyroidism). If you go to the website and click on THE EXPERIENCE and select THE SCIENCE from the drop-down menu, you will see a link to the THYROID video I am referring to. Basically, he says that the thing that surprised him about OsteoStrong is how they were finding hidden causes of bone loss because if after one year of doing OsteoStrong ppl aren't seeing improvements then there is something else going on. If there were an OsteoStrong within 100 miles of my home, I would gladly drive there weekly to give it a shot.
Additionally, I am considering purchasing the Marodyne LiV platform but I just had my first zoledronic acid infusion in November and I am working on getting my diet, exercise, and supplements "right". My last DEXA was in July 2021 my lumbar t-score was -3.7 (so it went from -3.9 in 2019 to -3.7 in 2021, which is not statistically significant). For info on Marodyne LiV go to melioguide.com/osteoporosis... and melioguide.com/osteoporosis...
I didn't have any bad side effects from the zoledronic acid infusion. At first, my endocrinologist put me on alendronate but that caused digestive tract issues so he then recommended zoledronic acid. I had asked about natural ways to improve my bone health but he really didn't provide any advice. I learned about LIV and OsteoStrong and vitamin K2 and the prune study and the almond study through my own research. Currently my plan is to NOT get another Zoledronic Acid infusion, at least not this year, and to monitor my progress through natural means. Also, my doctor did not rule out other possible causes for my bone loss, which I find infuriating, and I didn't find that list of tests on the BetterBones website until after I'd had the infusion.
Why didn't your doctor suggest you start with oral bisphosphonates 1st? From what I have read, they are much less likely to cause ONJ. Also yesterday I heard about Fosteum, I have no idea if that would help/work but it could be worth looking into.
I have increasing osteopenia and my MD wanted me to start the oral bisphosphonates. I elected to add the Calcium, Vit D3 , K2 supplements and exercise first. I learned about OsteoStrong and jumped on that option. I have been going for 1 year and am amazed at the strength I have gained. In addition, my bloodwork shows an elevated ALP, which is an enzyme associated with bone as in the case of fractures. I am taking this as proof that my bones are reacting to the impact of OsteoStrong machines and laying down new bone. I won’t have a DEXA for another year, but I am very hopeful that I will be able to delay or never take the meds.I highly recommend OsteoStrong for anyone who can access it. It is quick, painless and takes literally 15 minutes/week.
Thank you so much for taking time to write. I would love to stay in touch since we have similar scores. I am researching all your suggestions today and they look good.Thanks
They stress that the risk of fracture outweighs the risk of ONJ, so that's something to consider. With your invasive dental work and periodontitis, you are in the higher risk category on that side of things, but on the other side, people getting treated for osteoporosis receive lower and less frequent doses of bisphosphonates than people taking those medicines for cancer, so you are on the lower risk category there.
Another thing to consider is your overall fracture risk besides your bone density score. I recommend you fill out the American Bone Health Fracture Risk Calculator™, which will take into account a variety of factor to give you an estimate of your risk of breaking a bone in the next 10 years. It is scientifically validated, and it only takes a couple minutes if you want to try it out: americanbonehealth.org/calc...
Osteoporosis is one of those conditions where your risk rises with age, so all things being equal, you will be at higher risk of fracture in 5-10 years.
Finally, see if you can find a physician who specializes in bone health/osteoporosis. This can be a very complicated condition to treat, and you need someone who knows what they are doing and will take into account your preferences and concerns.
I’m sorry to hear of your trouble. I am a dental hygienist with 40 years of experience. Even without osteoporosis, it is important for people to treat their periodontal disease, as it has more impact than just orally. Although it is so important for aging populations to keep their teeth so that they can actually eat nutritious food, periodontal disease is a bacterial infection and that bacteria can travel to other organs causing heart disease etc. So, treat the perio regardless. And…your MD/DDS are correct that any teeth that appear to need extensive treatment (extraction, root canals, perio treatment etc.) should be treated prior to bisphosphonates. However, the oral medications do not statistically propose the same amount of risk as the IV. Those are the ones which really heighten the ONJ risk.
I have osteopenia and my MD wanted me to start the oral bisphosphonates. I elected to add the Calcium, Vit D3 , K2 supplements and exercise first. I learned about OsteoStrong and jumped on that option. I have been going for 1 year and am amazed at the strength I have gained. In addition, my bloodwork shows an elevated ALP, which is an enzyme associated with bone as in the case of fractures. I am taking this as proof that my bones are reacting to the impact of OsteoStrong machines and laying down new bone. I won’t have a DEXA for another year, but I am very hopeful that I will be able to delay or never take the meds.
Thank you so much for all the helpful information. I have started a folder of all my bone health info. There is so much info out there on the Internet but I prefer talking to people who are facing the very same problem as me.
I am definitely going to try the things you suggested.
AimeeRU4me, I would suggest looking into the possibility that you have hypophosphatasia (HPP). It is a rare disease but affects bone and teeth. Many endocrinologists are not very knowledgeable about this but there is a lot of information out there that may be helpful to you. It is something worth investigating. Please look at softbones.org.
I wanted to add that treatment for osteoporosis is completely at odds with the treatment for HPP so if you do have HPP, osteoporosis treatments can potentially make it worse. Your dental issues, fatigue and dexa scores do suggest this is a possibility so I do encourage you to look into it. Many people are misdiagnosed. I wish you the best!
hi there, I just went to an Endo and she recommended Evenity ( or Tymlos) Evenity came out in 2018 or so and is newer and is not a bisphosphonate. I told her I needed dental work and she said go ahead as it won’t bother your bones. It’s taken for a year but then you have to go on Reclast..( I said no to prolia..) but I’m worried about prolia…she said you go about 5 years on it and then take a holiday from it…no more than 7 years is reccomended…has anyone else started Evenity? I hope this helps with options…
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