Prolia and dental extraxtion: Hello, I am taking... - Bone Health

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Prolia and dental extraxtion

Hello,

I am taking prolia for 4.5 years . The last prolia injection was a year ago- can I go through a dental extraction and implant?

Thank you

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What does your dentist say?

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Agree, get dentist to contact your clinic(osteo) that prescribed Prolia

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Hello Orsh,

I am also taking prolia. My dentist referred me to an oral surgeon for the extraction. He did the extraction but was hesitant about an implant. He suggested getting a bridge, which I did. Good luck with your procedure!

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Hello Mollymeer,

Thank you for the quick answer.

Did you stop taking Prolia before the extraction? Do you know why was he hesitant regarding the implant? I am asking this because my dentist suggested extraction & implant at the same visit, I am hesitating.

Thank you very much.

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I did not stop taking Prolia as I have not had any bad side effects. The oral surgeon said there may be a slight risk of getting osteonecrosis of the jaw (ONJ). So, I opted for the bridge.

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I know why the dentist was hesitant regarding implants! Because be drilling into the jaw bones, it is weakened extensively because of the bone meds! It's not good bone that is built up with these drugs, therefore the no implants!

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Thank you

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Discontinuing Prolia (unlike the bisphosphonates) may result in something called "rebound osteoporosis". If anything one would suspect that discontinuing this particular drug would put you at more risk of dental complications so it's worth doing a lot of research before doing anything invasive to your jaw.

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I have the problem of being on Prolia for about five injections and right now my front four tooth permanent bridge has pain in one of the abutment teeth. Those are the drilled down ones which hold up the bridge. Root canal has not stopped the dull pain in that tooth and gum is irritated. Was put on antibiotic prior to root canal.

No answers except root canal tooth could have a crack. It would mean removing the bridge, extracting the root canal tooth. Risk of necrosis because I would need an implant. Oral surgeon had success with a person needing removal at four months away from his last Prolia injection. Root canal dentist and regular had no suggestions. I find by questioning that few know much about Prolia. Would like more answers from those who successfully had extractions while being on Prolia or other osteoporosis drugs.

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Well, good luck. It is encouraging that the oral surgeon has had successful experience performing the procedure. You can't allow low grade infection to continue so something will have to be done. Do check into what kind of nutrition will help you heal; I don't really know but I imagine protein is important.

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My experience with Prolia has destroyed my life I only had two injections. I had to have an extraction my first because Prolia destroys your teeth. I was six months away from my last shot and so I had prayed about it and decided to go ahead with an implant; it was successful One doctor would not do it because of the OMH problem history of Prolia. I’ve heard of people having bad experiences but I believe that the Lord covered me in this case. The specialist that pulled my tooth and put in the implant had me come once a week and kept an ion it for two months. You couldn’t pay me to get another shot Of Prolia. I am still bedridden from severe back pain. My doctors don’t believe me that's from the shots; who cares I know what happened to me. Have your doctor give you am just pamphlet now. It finally warms of the side effects. When I had my shots there were no side effects in their brochures in fact there were no brochures! The doctor just pitched it. So guess who pitched the doctor? The sales rep people use your heads and wake up Maybe then we could get some action out of Amgen and the FDA

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My endocrinologist recommended I wait until six months to have my dental work (effect of Prolia diminishes each month) even though periodondist didn't agree. I chose safe side and waited six months and had extraction and implants at same time. I had also had an extraction several months ago while Prolia was effective but tooth was abcessed and had to be removed. No one should go without replacing Prolia if discontinued. I have now taken it for four years.

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Thank you Louisewj for the answer. Could you please say how many years you took prolia (how many injections) before the first extraction and implant?

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I had taken Prolia for 3.5 years before first extraction that was done in the middle of the six month treatment being it was an abscess that had to come out. This most recent work I waited six months at recommendation of Endocrinologist to have extraction and two implants - all done at same time and that was at 4 year mark. I've read there is only a 1% chance of having a problem having implants while on Prolia.

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I understand that at the time of the extraction, it was time to get your injection. Did you delay the injection while getting implant?

If so, how long did you wait to get your next Prolia?

The implant I think takes up to four months to be ready for a cap.

Would appreciate all details because you are the only one I know who did this and without necrosis. Thank you for any help.

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See reply above. Implant takes three months, not four so the two will be ready for their porcelain tops the month I will be getting my next injection.

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I've been taking Prolia for 4.5 years now.

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Thank you. So difficult to find anyone who has had extractions and implants while on Prolia. I was told by a woman who works in a dental office that extractions done by Surgeon are different from Periodentist. She said the surgeon cuts around the tooth to extract while the Periodentist pulls to extract. I have had one of each. Now I wonder if the pulling would be less disturbing to bone than surgical extraction? I am tempted to use the Oral Surgeon but concerned about the bone being affected more. Any thoughts?

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I would use a periodontist that has a high rating - no reason for a surgeon as that is what they do (there are a lot of regular dentists doing implants these days like regular doctors doing plastic surgery). Can't imagine why the gum would have to be cut open. I had two implants. For one the tooth had to first be extracted and the periodontist (who is rated one of two top in Pasadena, CA) first cut the tooth in two pieces he explained because it had two roots. I assume that prevents more trauma to bone, don't know. They told me because it was an extraction, there would be a slight space around the implant while it was healing. It has been about a month and that has closed in nicely. Two more months I go to the dentist who does the tops and perio will send paperwork with me to give dentist all info he needs (some need to know for sure which tools). I'm using a new dentist since I moved who was recommended. He does the implants but I'm only using him for the tops and will use him for regular work that I need. I have used my periodontist for 33 years when I first had to have periodontal surgery and since I have had several implants so wouldn't trust anyone else.

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I have to go through an extraction of 2 teeth and was on Prolia for 3.5 years.

I am not sure which kind of specialization would be better for the extraction -

Oral and Maxillofacial surgeon or a Periodontist - who should I go to?

Thank you very much!

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Orsh, you didn't say if you also needed implants. When I lost the first tooth, I went to a regular dentist and she couldn't get tooth out and felt like she was destroying sinus and she mentioned root was too large. When I was at my periodontist for annual cleaning, he said he would remove it and did it with ease (she worked on it for two hours). When I lost the gold inlay in the one next to it, periodontist removed it with ease and said he cut it in two pieces before removal as it had two roots. Apparently that is what she should have done. Four weeks ago he put two implants (the screws in) and in February I'll go to a regular dentist to have tops made. BTW, he put the implants in the day he pulled the second tooth.

This is what is said online for each: "The bottom line is that a periodontist focuses on implants and gum health, while an oral and maxillofacial surgeon can perform a wide variety of surgical procedures on the mouth, jaw, and face.Jun 29, 2017" reason I said a good periodontist can do the job.

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Mollymeer, for how long did you take Prolia before the extraction?

I am hesitating regarding the extraction since I already take Prolia for 4.5 years

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As I stated above, I waited until six months since Prolia's effects diminish each month, reason it has to be repeated every six months.

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what I mean is - how many prolia injections you had in your life?

that is also a parmater.....

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Twice per year for four years makes it eight injections.

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How much time went by from your last Prolia until you resumed it

While having this work done and did you take any other osteo drugs in the interval? I have read Govt. reports that Several months after stopping Prolia, vertebral fractures can begin. That is why i was asking how long between the injections. I am really afraid of necrosis from extraction where the bone dies and the implant will not hold. Thank you in advance for any info.

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Since the effects of Prolia only last six months, decreasing each month, doctor told me to have the work done at the end of the six months. I will run over six months getting the next injection by two months since I had breast surgery and have scheduled my visit for injection at time of my follow-up breast exam and don't wish to go longer than that.

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Yes, do not delay more than that. I read a report that when stopping a Prolia without starting on one of the osteo pills, about four months or more some experienced fractures or reverting back to pre-Prolia condition.

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Yes, thanks as I don't intend waiting longer than the two months.

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I just read if a woman who was supposed to get her next injection at the regular six month interval but her Dental office failed to set it up on time and on the seventh month, she had fractures.

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I have put in here my Periodontist doesn't ever see there is a problem but my Endocrinologist had me wait after three months before next Prolia injection to have my extractions and implant surgery to be on safe side.

New news is I was overdue for my Prolia by two months as I needed to coordinate appointment with another doctor. Today I had my Prolia injection and doctor said since I was on Fosamax previously and then Prolia for five years, six months from now she wants me to start Reclast annual infusions. She also doesn't want me to have dental surgery for three to four months now that I have had Prolia injection. As you know, it gets weaker each month in your system and is nonexistent by end of six months.

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Orsh, The first thing the dentist asked before he started the implant was whether I has ever taken ANY bisphosphonates. If I had, he would not even begin the process.

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Thank you

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Apparently your dentist hasn't done the research. Chance of having dental problems are 1%. I waited six months since effects diminish each month and had extraction and two implants and no problems. Several months ago had an extraction as well. It was done by a periodondist whom I have seen for 33 years believe it or not, and is one of the two top in Pasadena, Ca.

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Thank you louisewj.

How many Prolia injections you had before the extraction (how many years)?

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I think your dentist should do more research, or he is just too afraid to have a problem. My Periodondist, who is fearless, is the top one in Pasadena, CA and been in practice for 33 years I have gone to him and we've never had a problem. I even had to have an extraction in the middle of one Prolia injection but it may depend on individuals.

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My Dentist would not do implant because if my low bone density with or without the complication of medication. You should be wary of a Dentist who is in such a hurry to take such actions. I chose my new Dentist based upon his experience in this area.

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Thank you

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Hi I had to have a tooth extracted on Prolia. My dentist wouldn't touch it so I had to see a maxillfacial surgeon. I doubt very much if a dentist would do an implant because of the perceived risk to the jaw. Good luck.

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Thank you for thew reply

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My Periodontist I've seen for 33 years didn't hesitate. As I previously took Fosamax for as long as I could before it would start having reversal affects and then went on Prolia four years ago. Articles I have read say there is basically only a 1% chance of having problems although I waited six months before the extraction and implant since Prolia's effects diminish over a six month period - reason it has to be taken every six months.

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How far away from your last Prolia at the time of the extraction? Thanks.

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Hi Jayge I had the extraction 3 months after the prolia injection

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How long after the extraction before resuming Prolia? I guess what I am asking is Did you resume at your regular next Prolia date?

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Hi yes I had my next prolia injection as scheduled.

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Deb, did you have an implant and if so, how long after the Prolia injection?

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I don't see the difference. A regular dentist, maxilifacial surgeon or periodondist pulls the tooth in the same manner but surgeon may charge more. :) I just had one extraction and two implants nine months after Prolia injection (to be on safe side) and one extraction during the Prolia as tooth had to come out.

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Did you stop without going on some other drug?

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My dental experience is pre prolia. Had 2 extractions with fun disease. Told there was insufficient bone for implants. 2 months post 2nd extraction had bone density and told hip just in osteoporotic range! Dr suggested prolia but need clearance from dentist. This was given and prolia given. Have since been concerned about mouth as bite not normal! Have appointment to see a periodontist for 2nd opinion. Not happy to have 2nd prolia and have made decision to stay with supplements and exercise.

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