Osteoporosis and Dental Implants (video & text)

(updated July 2022)

Is it possible to have dental implants if you have osteoporosis?

What if you took Fosamax, Boniva, Zometa, Prolia or one of the medications intended to slow down the process of osteoporosis?

What if your T score is -4.2?

The short answer is yes… Having dental implants is possible with osteoporosis, but everything must be done a bit differently than if you did not have osteoporosis.

You are losing more bone cells than you are gaining.

Watch the video below and ask questions in the comments section. Also, be sure to check out the article I wrote and published on the The American Academy of Implant Dentistry website (you can read it here).

Video Transcription:

The topic is osteoporosis and dental implants. Can you have dental implants with osteoporosis?

Well, it depends, but the general answer is yes.

And it’s going to depend on how it was treated and if it was treated. Let’s go into it a little bit.

What is osteoporosis?

So basically, osteoporosis is more common in females than it is in males. It’s a process where your bone can become more brittle/soft because you’re losing balance of the bone cells.

You’re supposed to have a certain amount of bone cells that are making bone and certain bone cells that are breaking down the bone.

We call this osteoclast and osteoblast. One that makes, one takes away.

That’s a balance, just like your skin rejuvenates itself and becomes new, and some people will go through the process of making their skin smoother because they want new cells, new bone, new turnover of skin cells.

The same thing is in the bone.

Your entire skeleton replaces itself. Every bone in the entire body does that.

So if you think about it, having a dental implant, it depends on bone healing. Right? You need bone to attach to the implant. So if we don’t have bone attaching to the implant, or we don’t have as many bone cells, it might take longer. It might have a little bit of a lower success rate.

But it has to be handled differently, especially if you’ve taken a medicine that is meant to treat osteoporosis. Those are called bisphosphonate medicines. The most common are Fosamax and Boniva. Those are the oral pill forms. And then there’s other forms which are injectable, which are much more potent. I’ve written some articles on that, as well.

Managing osteoporosis

So let’s talk about management of osteoporosis. In the way that I do things, if I know the bone is softer, the osteoporosis may have not affected the upper and the lower jaw directly, but the bone is usually a bit softer, especially in females.

So, that means…

  • I might compress the bone.
  • I might densify the bone.
  • I might connect the implants together.
  • I might use a special type of implant.
  • I might use remote anchorage like into the zygomatic/pterygoid bone if you’re missing all of your upper teeth, or we might not do as extensive of bone grafting or have to use more of your own bone if you have osteoporosis.

If your T-score is really high, those are things you have done on a DEXA scan, then it’s a possibility that your doctor prescribed you a medicine to treat the osteoporosis. That can cause a complication called medication-induced osteonecrosis of the jaw, and that can cause the jaw bone to actually die or not heal or become exposed.

So, there’s some tests. There’s some controversy on whether those how valid those tests are.

But each and every person has to be managed individually with other risk factors, such as diabetes, steroid treatment long-term, to see whether you’re at risk for osteonecrosis, where the bone would die from taking these.

Osteoporosis and dental implants – is it possible?

So it takes a dentist who really knows what they’re doing to manage a patient with osteoporosis, especially for a full arch or full mouth dental implants replacement…especially the upper jaw, because it’s much, much softer.

So the bottom line is, yes, you can have dental implants with osteoporosis.

It just needs to be managed differently, and your dentist really needs to know the ins and outs of your medical history. I would suggest definitely seeing somebody who has a lot of experience in this field.

Osteoporosis typically affects the hip and the spine, and sometimes people get wrist fractures, as well. But in general, we just have to, again, handle things much differently with perhaps a blood test if you’ve taken one of those medicines, such as a CTX, and adding in blood platelet concentrates, like taking blood from your own arm, concentrating it, making LPRF, using that to enhance the healing, to attract the right cells, to get things going, and again, different techniques, different types of implants, different loading protocols.

There’s a lot to this. It’s not just put a screw in and hope it works or have it as some sort of an afterthought.

But again, if you have comments or questions, please write them in the comments below (not necessarily leaving comments on YouTube), as the blog is much more active for questions. Thank you so much. Take care. Thanks for watching.

16 thoughts on “Osteoporosis and Dental Implants (video & text)”

  1. I sent my question via my iphone and not sure it went thru so apologies if this is a duplicate…
    I had an implant placed which fell out when dentist was preparing to place crown. I was supposed to go back to have it done again but oral surgeon had left practice so I went to a different practice who started with bone graft which included human growth hormones. Two weeks later I had an accident which resulted in my upper lip (where implant was placed) being hit. That night the whole implant came out. Dentist is willing to replace implant but is concerned because he says the implant should not have come out that easily since it was screwed in pretty tight. As much as I prefer an implant wondering if I should give up and get a bridge. Thank You for you opinion!

    Reply
    • This is very odd. If you had the implant for more than 4-6 months and it was integrated there is no way that the entire screw could fall out unless it had a previous problem. I think you need to see an expert implant dentist to replace it but this all sounds very strange. It is possible to break off the implant and the abutment but for the whole implant to come out and the other teeth remain intact would be a mystery. Without seeing you I cannot really tell for sure of course.

      Reply
  2. Hi please help had implant top right jaw about 2 years Xmas it started feeling sore but told nothing wrong went back again nothing went to another dentist took scan said everything is fine the pain I can’t stand no more

    Reply
      • Hi thanks for replying, it just starts to feel sore then the pain starts! The dentist said the scan showed all bone around the screw nothing wrong feel like I’m going mad I live in England is it a problem if I get some one to take it out! Will it effect my jaw bone regards

        Reply
          • Hi I still have the implant,still would have the pain
            Felt like my life was over| but tried amtriplyn 25 mg once a night! Has really help a lot/ some days I can feel it start again but I have more good days then bad\ put me off having more implants just hope I can keep hold of my teeth/ thankyou for taking the time to reply regards sandraa

  3. I have Metastatic Breast Cancer in my bones. I’ve had a biopsy of the dead teeth and have no cancer in that area. I’ve had an implant removed in March 2020. Covid hit – unable to see Dentist for a few months. Now I have a large hole that is not healing. I don’t necessarily want dental implants, but can that large hole be filled in, or can some kind of appliance be made to cover it. I’ve had numerous infections. Right now I am being treated with Chlorexidine, antibodics if needed and a watch and see what happens. No treatments are being done. I’ve been told that any treatments I receive concerning the dead bone in my mouth would worsen my situation.

    Reply
    • Hi Marie,

      I am sorry you are going through this. ;-(

      It is not safe to place implants into the bone in this situation for sure. You can have a custom obturator made to cover the hole when you eat. Very few dentists know how to make these so you will need to research or go to a dental school.

      Be well,

      Dr. Amin

      Reply
  4. Dear Dr. Amin,

    I recently watched your video on implants and osteoporosis. I am a 63-year-old female and I’m wondering if a dental school would be the place to be, especially with faculty dentists overlooking the implant process. I’d like to have my upper arch replaced, but I haven’t found a surgeon in Northern California (Sacramento County) who has the requisite skills to manage patients with osteoporosis.

    There are two dental schools in San Francisco, which will hopefully reopen after the CDC Coronavirus guidelines allow it. What is your impression of a school being able to handle this problem?

    I’m very grateful for your insights, as are many others who comment on your blogs. Thank you.

    Reply
    • Thank you for your kind words. Replacing the upper arch is by far the most difficult surgical and prosthetic procedure in all of dentistry. You are right to do a lot of due diligence considering her osteoporosis. In a dental school you can certainly have excellent dental care. Be warned that it will take a very long time to complete and they typically do not offer advanced procedures such as immediate teeth. I know this because I taught in a dental school for many years.

      In my practice, almost 100% of patients have an immediate fixed Bridge put on to their implants on the same day of the surgery. That means that you do not wear a denture at all which can benefit the patient with osteoporosis because you are at risk for what we call “crestal bone loss.” Some upper jaws are very challenging because they are typically hollow due to large sinuses and nasal cavities requiring alternative procedures such as zygomatic and/or pterygoid implants.

      In a dental school you will be treated by many different providers and different departments. If you have a lot of time and this may be a good solution for you. Just keep in mind the process is very slow. The cost savings is not significant in implants because of the very high overhead. You are welcome to come see me for an opinion. I see many many patients who travel from all over the United States. I am in Southern California. Regardless, good luck and stay safe during COVID 19!

      Reply
  5. Hello Dr Ramsey Amin, , i just saw an article on cone beam scan vs conebeam and c t scan done together, (CBCT)and it was presented as the combination of CBCT
    showed a more comprehensive combination of views re the whole state of mouth jaw joints sinus areas along with the bone density,/ would you agree agree with that test as being the best test to have …kindest regards ……Julie🙋‍♀️

    Reply
  6. I am scheduled to have 6 implants in my upper jaw placed. My dentist did a sinus lift and ridge augmentation. I have been researching the best option for full upper arch bridge and it appears Prettau is the best. Once the titanium implants are placed can I then see a dentist that does the Prettau bridge or do I have to coordinate with the two dentists prior to the implant placement.

    Reply

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