prolia forever vs dental work

i am. 76 year old woman with advanced chronic kidney disease. I am just starting my 3rd year on Prolia (injection #5).

I did not adequately research the med before starting and my endocrinologist was not very forthcoming about the downside. So I took her advice and here I am - stuck.

Me recent scan showed improvement in bone density (+6%) . However I my dental situation is very much on the edge. The possibility of jaw necrosis scares me. At some point I will likely need additional extraction(s).

Even if I stop Prolia now, the increased risk for necrosis will extend fir some time into future.

has anyone dealt with this issue?

[stacylynnpelle]

Follow Dr Doug Lucas at Optimal Bone Health, on Youtube, he does take new pts, it is a little pricey but he could possibly help you

[laniado]

as a dentist who has dealt with this issue if you can time extraction after the 5 month mark you should be safe. There is also a blood test to take to before any extraction is done to check blood levels of Prolia. Your surgeon should advise you.

[Hidden in reply to laniado]

Thanks so much for this info.

[Raleigh59]

My endocrinologist said once on Prolia you will be on something the rest of your life in order to not have a dental problem or loss if density. So when you go off Prolia you are supposed to already have your replacement shots or tablets scheduled and taking them in order to not have a rebound and lose bone density and in order to help your teeth.

I don’t know if it’s true but some of the medicines for osteoporosis are supposed to strengthen your teeth and jaw bone like Tymlos. Women say it’s true and attest to it. I personally am on Tymlos myself but it’s self injections which is not my favorite but the medicine has its advantages.

[Hidden in reply to Raleigh59]

Thank you. Is Tymlos a daily injection? I will have to Look that one up. Not familiar.

[kitty7]

Hi: After reading your post I think I'm in the same situation as you. I'm starting my sixth year of Prolia injections and I can't find anything to replace it. Everything I've looked into is super expensive and I can't afford it. So, much to my dismay, I have to stay on Prolia for the rest of my life. I'm 81 years old and Prolia was ordered by my oncologist when I had breast cancer at the age of 75. I've had dental surgery and an implant placed while on Prolia I just postponed the injection for two months. I was scared when I had the dental surgery but all is well I'm happy to share I've had no trouble and that was five years ago. Good Luck!

[Hidden in reply to kitty7]

It sounds like you are doing well! That is good news. Thank you for the info.

[Copper23]

I was on prolia for 8 years and needed a front tooth extraction. I was very concerned about necrosis of the jaw. My last dose of prolia was April 2022. I had the extraction Sept. 2022, an implant Feb, 2023, a healing abutment July 2023, and finally the crown August 2023. I was scared the entire time. It is now Dec 2023 and I tried Fosomax (2 month) starting in September but I experienced extreme GERD so I discontinued it. As of now I am not taking anything for osteoporosis and am considering going back on the prolia. AS far as the extraction / implant process I had no problems. I am 75. It all was a hard decision. That was my experience. It wasn't as bad as I thought it was going to be. There is no good answer.

[Hidden in reply to Copper23]

Thanks. So no rebound fractures from going off Prolia? That's great !

[Copper23 in reply to Hidden]

I worried about rebound fractures. So far so good. When I started with the Prolia I was not aware of the problems with it. Not sure if I would do it again.

[KidneyCoach]

I'm on dialysis so the end stage of chronic kidney disease. I was prescribed prolia by an oncologist referred to by my GP. I have multiple compression fractures in spine with scoliosis due to bone loss. I was very concerned about prolia but agreed to first injection. After 2 months my blood calcium dropped to near critically low levels and I ended up with a hairline fracture in Tibia. I chose to stop Prolia and they insisted I replace it with a synthetic Parathyroid hormone which for dialysis patients causes serious complications. The oncologist and GP were clueless. I chose (after consult with kidney specialist) no replacement at all. I have broken several toes and needed 2 extractions on abcessed teeth in 7 years but nothing else. Blessings

[Hidden]

Thanks. I hope you continue to do well!

[Hidden]

same here…except my Primary doc put me on PROLIA the minute I went from ‘penia to ‘osis….then mismanaged my care for 4 years before I saw the light being late with injections. What a dope I was…

But I’m taking my first Reclast injection in 45 days (also a very scary drug) a Relay drug to transition off PROLIA. Now I have an Endo (who doesn’t have time for me nor has a grip on the seriousness of these drugs imo). She’s never heard of REMS (a newish, better test of bone strength) and has been reluctant to budge on any of her opinions. So I’m searching for a new doc. She also insists on 3 years of reclast where many other sources say 2 years, of course depending upon next bone results.

I’ve joined Osteo Strong to exercise for bone strength & eating my calcium & protein, plus some vitamins etc for an overall health.

I believe in osteo strong, members all report non-drug improvements I trust less in drugs & more in my own research. I really appreciate this forum!!! I’ve learned so much!

Best to you on your journey❤️

[Copper23 in reply to Hidden]

I am a seasonal resident of the The Villages in Florida. We have a program called Bone Builders which they say is research based and developed in Boston. Supposedly it can stop the progression of osteoporosis. I do it 3 times a week - it's is tiring but seems to be very well thought out and often physicians here will recommend doing it for osteoporosis. It can be found on u tube - just put in the Villages Bone Builders and several u tube videos will come up. If I don't make it to a class I just do it at home.

[Hidden in reply to Copper23]

Thank you! I’ll look into that. I appreciate your help

[usr2022]

A very useful video:

Osteonecrosis of the Jaw (ONJ) & Osteoporosis Drugs - oral surgeon, Dr. Hassan Moghadam

youtu.be/a974_VxC07o(Not working as expected?)

[Hidden in reply to usr2022]

Watched. Very useful. Thank you.

[Hidden in reply to usr2022]

Thanks, great info.

[AnnieB52]

Di04, I understand your concern. I have been on Prolia a few years now. I never wanted to start it but my pcp finally talked me into it. Anytime I have voiced my concerns I get comments like all medicines have side effects even Advil, etc,. When I asked what I should go on to when I needed to come off Prolia, I was told I might never have to come off it. I have not had any problems that I know of yet but it must not be helping much as I have had a compression fracture at L1 since September with lots of pain. It's hard to know what is best sometimes and we don't always get much help from our pcp's. I wish you well.