Prolia and dental work

Posted , 8 users are following.

HI All,

I have been on Prolia since February and have had two injections. Prior to that I had any necessary dental work done, as was told that no extractions etc could be done while taking it.

Out of the blue I now have a tooth sensitive to hot and cold, and cannot chew with it and I fear a nerve is causing the problem. I am also on prednisone for PMR/GCA although have managed to reduce from 50mg to 2.5mg over the last 18 months.

My fear is that I may have to have the tooth out, as my jaw and neck are now aching on that side, and I'm very concerned as to what is ahead as far as dental work goes, I know it can be very complicated. I'll be seeing the dentist today if she has an appointment.

I'd be very grateful for any advice or experience of dental work while taking Prolia as needless to say I'm petrified.



0 likes, 6 replies

6 Replies

  • Posted

    I also take prednisone and have PMR . I am guessing from the dosage you started at that you had GCA as well . I'm also very surprised that you didn't have any problems tapering as fast as you did . To go from 50 to 2.5 mg in 18 months is unheard of . I've had PMR for a little over two years and I started at 20 mg and I'm now at 4 mg . I had a really hard time getting past 11 mg . But once I did I've been tapering pretty steadily since without a problem . however once I started prednisone in the beginning my teeth became very sensitive to cold . going to the dentist have my teeth cleaned was suddenly very painful. And someone in the PMR group on this site said that prednisone will do that to your teeth . I believe the sensitivity will stop when I stop prednisone. I have also taken my first Prolia injection just about a week ago. my doctor didn't say anything about not having teeth pulled. if you're having a nerve issue in your tooth they will more likely want to do a root canal and then cap it and not pull the tooth. I don't know if that's something that's allowed when you're on Prolia or not. but you certainly should ask the doctor who is managing your PMR / GCA.

    • Posted

      Thank you for replying amkoffe. You're quite correct, I do have GCA as well as PMR, and yes, I tell my husband quite regularly how lucky I am that I have been able to reduce this far in this short time. Trust me, I did everything by the book to get there, my rhuemy had me on a much faster descent but I introduced him to the DSNS method at about 12mg and he agreed to let me judge myself when to drop. I now only do half a mg per month and I let my body do the talking. I pace and rest a lot. While I have had other side effects of the prednisone, sensitive teeth hasn't been one of them, and prior to having my first Prolia injection I had a full dental examination, and had a tooth out rather than risk root canal and possible tooth extraction further down the track while on Prolia. The tooth causing the problem has only had a crown put on it about 4 months ago after I broke the tooth so I have no idea what is going on there to have the tooth start to react to hot and cold and the jaw and neck ache as a result. One of the side effects of Prolia can be ONJ, better known as osteocronosis of the jaw. Rare I believe, and more common if undergoing chemo, which touch wood I'm not, but my rheumatologist advised getting a dental checkup pre-prolia, and my dentist filled me in as to what may happen should I need bone invasive work done later on.....not something I'm contemplating with relish! Guess I'll know more tomorrow.

  • Posted

    I would say that it sounds like that tooth has probably cracked more or the root has abscesses. I believe they can do a root canal through the cap so you don't have to get a new cap.

    I wish my doctor had told me of some of these problems with prolia. She didn't tell me anything except that it would heal my broken bones. I did look it up online. But I just kind of scanned the information but it didn't really tell me much as I recall .

    I wish you luck on that your tooth problem and I hope I don't have the same problems as you.

  • Posted

    Thank you all for your advice. I thought I'd give you an update. I had the dental appointment yesterday but when I woke in the morning my tooth seemed fine. Wasn't a problem to drink hot coffee or cold milk and the gum that had been tender was no longer sore to touch. Tooth still felt "funny" though so I kept the appointment. Dentist blew cold air on it... fine. Tapped it all around with a metal tool..fine. Took an xray of the problem tooth and the one beside it and there was no decay, no exposed nerve, no cracks, teeth looked fine EXCEPT the ligaments surrounding both teeth were wider than they should be which indIcates inflammation. No infection, so no antibiotics, just inflammation. She suggested taking antinflammatories but I can't while on prednisone. So she suggested heat packs against my jaw to try to get the inflammation down. At the moment it seems ok, but I'm to go back if it flares up again. I had no idea we had ligaments around each tooth so there was a surprise. Hopefully thats all it is and all remains calm in my mouth, otherwise there may have been a few expletives if I'd needed any work done. She did say root canal would be the next step IF there is further problems and that can be done while taking Prolia, just not extractions.

  • Posted

    I had my prolia injection on Nov 3, 2021, and the nurse told me that I cannot have dental works for 3 months. But out of the blue, but on Nov. 12/21, I woke up with a loose moral tooth on the left side up. My gums are swolen and I called my Indocronologist if I can go to the dentist and she is going to give me an answer in 2 days. Can somebody or any indocrenologist tell me about Prolia and dental works. I need help.

  • Posted

    I saw my rheumatologist (head of the department) a few weeks ago and she wants me to have the annual infusion (don't know which sort yet) as a medical condition means I cannot take it by mouth. I asked her about the danger of necrosis of the jaw and explained that I have terrible teeth (however well I look after them) and can easily have to have an extraction at a day's notice. Her response was that I have a 100% chance of another fractured vertebra without medication, whereas only a very slim chance of ONJ, and she thought that would reassure me (it doesn't!). What sort of choice is that? Breaking veterbrae or having your jaw bone rotting and dying?!!

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