Why I ask about these medications specifically

Bone in the jaw remodels constantly, and that remodeling is how an extraction socket heals. Medications that reduce remodeling can, in a small number of patients, leave bone exposed and slow to heal after surgery. Dentists call this medication-related osteonecrosis of the jaw. It is uncommon, and far less common with the pill forms taken for osteoporosis than with the high-dose IV forms used in cancer care.

Knowing what you take, for how long, and how it is given lets me put your actual risk in context instead of guessing.

What is usually fine

Routine and restorative care does not involve the bone and does not need to wait. In fact, keeping your gums healthy is the best way to avoid needing an extraction later, which is the procedure I most want to avoid on these medications.

• Cleanings, exams and X-rays
• Fillings, onlays and crowns
• Gum disease therapy and periodontal maintenance
• Invisalign and whitening

What I plan more carefully

Extractions, implants and gum grafting involve the bone. Before those, I want to know your medication, dose, how many years you have taken it, and whether your physician has discussed a pause. For many patients on oral bisphosphonates for a short time, we proceed with careful technique and closer follow-up. For longer histories, IV forms, or Prolia, I coordinate with your physician and our periodontist, Dr. Shah, who places implants and handles extractions here at mend.

I will not stop your medication on my own. That is a conversation between you and the doctor who prescribed it, and I will give them what they need to decide.

What you can do

Bring your full medication list to every visit, including anything taken yearly by infusion. Keep your cleanings so small problems stay small. If a tooth starts to hurt, call early. Saving a tooth is always simpler than removing one, and on these medications that matters even more.