OSTEOPOROSIS RX - Prolia, and my amazing dentist

This article made me think, but then everything makes me think about my osteoporosis right now.

http://www.kevinmd.com/blog/2015/09/

osteoporosis-a-silent-assailant-turned-me-from-physician-to-patient.html

The writer, an MD, was sure she was taking care of herself until the incident, the snap, the pain. The procedure on her broken vertebra had her back at work quickly and going for long walks.  My spine probably is in danger, too - no spine scan possible for me due to screws from the past lumbar fusion.   She and I both have to be aware of the strain on our spines right above and below the "fix."

And I still have so many questions about my plan to take Prolia.


Fast forward to yesterday at the dentist.  (All dental work has to be complete before Prolia because of possible side effects to the jaw.)

The dentist spent the entire afternoon on one tooth that my previous dentist did not even plan to treat.  An old crown had to be very carefully cut off.  Sure enough, there was decay in a space below that crown.
(The rumor is that some other dentists just won't go to the time and trouble to find and fix that.)

The assistant and I got into a talk about osteoporosis medicine.  She mentioned that some osteoporosis patients have been referred to my dentist because they had the jaw osteonecrosis these meds can cause.  (Think a dragon chewing on your jaw.)  My dentist had thought up a wonderful fix for one of them.

I'm blessed to have him - he takes the time the problem requires, and knows enough to create solutions.    Still, The discussion was uncomfortable.

 My oncologist's other patients have not had any of the scary side effects of Prolia.  And he does require a clearance showing all dental work is complete before the first injection.  I'm blessed to have him, too.

Recently, at my request, my dentist did a long and rigorous check of all my teeth, In two weeks, he'll be done working, and I'll be good to go with Prolia.

Yesterday, he remarked after recovering and rebuilding that tooth that my gum tissue is good.  That's probably thanks to the nightly ritual I learned from the L.A. periodontist.)  So that would help protect my jaw?  Right?


But, still, what makes those referred patients different from me?


Action:  I want to ask my dentist when I get the permanent crown and the last tiny cavity fix:


1.  Does he know if the jaw patients sent to him were taking bisphosphonates (like the advertised pill) or denosumab, like Prolia?  These two kinds of drugs work differently in the body, but both endanger the jaw and certain bones.  WHY?

2. If this necrosis is caused by lack of blood supply, how to I get more blood supply for my jaw? The internet hasn't been much help on that.  If he doesn't know?  What do I do?

I wish you health.