Mum on prolia 6 years, was going ok. Then over the past 3 years has had 3 teeth extracted. Upper mandible

[MayGodBlessYou]

Does the maxillofacial surgeon speak up if they thought it was early stage of ONJ, or do I have to ask him somehow?

Or does she see her endo and discuss?

Or can the GP reappraise?

Mum got talked into 6 years ago, it after first turning it down for a couple of years. I wish she never started, but I didn't know.

It would explain the tooth extractions, and some cellulitis she had a few years ago.

I don't like the direction the teeth are going. One tooth next to the recent socket has a black crown, and there's a couple of 3mm dark red spots on the hard palate, 20mm apart, near the socket.

If there weren't side effects, I would be relatively happy with the treatment, even though I doubt she needed it in the first place.

Because of the extraction, she missed a scheduled shot.

I think now would be a good time to switch to something,

though it seems they're all pretty bad.

But I must act this week, as her scheduled shot is in 2 weeks.

I only read about ONJ yesterday, as I was reading. 😔

I had been interested in dr Aliya Khan's prolia half-dose paper,

but now I want to ask the docs if it's time to change.

Maybe fosamax, from my reading.

She might be a bit 'scared' to ask drs, in case they're offended.

[yogalibrarian]

Here is the safety info from the Prolia website (proliahcp.com/):

Osteonecrosis of the Jaw (ONJ): ONJ, which can occur spontaneously [not associated with medication] , is generally associated with tooth extraction and/or local infection with delayed healing, and has been reported in patients receiving Prolia®. An oral exam should be performed by the prescriber prior to initiation of Prolia®. A dental examination with appropriate preventive dentistry is recommended prior to treatment in patients with risk factors for ONJ such as invasive dental procedures, diagnosis of cancer, concomitant therapies (e.g., chemotherapy, corticosteroids, angiogenesis inhibitors), poor oral hygiene, and co-morbid disorders. Good oral hygiene practices should be maintained during treatment with Prolia®. The risk of ONJ may increase with duration of exposure to Prolia®.

For patients requiring invasive dental procedures, clinical judgment should guide the management plan of each patient. Patients who are suspected of having or who develop ONJ should receive care by a dentist or an oral surgeon. Extensive dental surgery to treat ONJ may exacerbate the condition. Discontinuation of Prolia® should be considered based on individual benefit-risk assessment.

You haven't mentioned your mother's age or other medical conditions. But keep in mind that ONJ is extremely rare about 16:100,000 (and often related to some of the other medical issues mentioned in the safety info) and the risk of a life-altering/life-ending fracture is much higher, 1:2 (for a woman over age 50).

P.S. If your doctor is offended by legitimate questions -- find a new doctor.

[krpf]

I would highly recommend requesting to join this Facebook group over 9,000 on it with a lot of very helpful information - m.facebook.com/groups/98854...

[MayGodBlessYou]

the study on bisphosphenol and ONJ excluded women who'd been on bisphosphenol over 3 years !nps.org.au/australian-presc...

this is grievous

[MayGodBlessYou]

alright, i read in a couple of papers that 'the cause of onj /mronj / necrosis is unknown'. so they know there's a cause, singular, not 'causes' plural. well I'd say that we know what it is. the dental surgeon knew.

the mechanism would likely be to do with the stopping of the bone cycle, should be obvious how stagnating that is.

please don't be under-informed about these drugs

my Mum has for years had side effects, didn't attribute them to the drug as she and docs are under-informed,

[MayGodBlessYou]

Mum's friend has 2 teeth needing extraction, jaw i think.

found out recently she's on prolia, i don't know how long for

dentists and dental surgeons need to communicate more with doctors,

dentists probably have long made the link between tooth damage and prolia