{"id":24304,"date":"2026-10-27T22:12:40","date_gmt":"2026-10-27T22:12:40","guid":{"rendered":"https:\/\/aclinicadrpedromota.pt\/bisphosphonates-and-denosumab-what-your-dentist-needs-to-know\/"},"modified":"2026-10-30T17:21:06","modified_gmt":"2026-10-30T17:21:06","slug":"bisphosphonates-and-denosumab-what-your-dentist-needs-to-know","status":"publish","type":"post","link":"https:\/\/aclinicadrpedromota.pt\/en\/bisphosphonates-and-denosumab-what-your-dentist-needs-to-know\/","title":{"rendered":"Bisphosphonates and denosumab: what your dentist needs to know"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"24304\" class=\"elementor elementor-24304 elementor-24030\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-69ccd57 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"69ccd57\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-extended\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-cf49ef5\" data-id=\"cf49ef5\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-8d3780c elementor-widget elementor-widget-heading\" data-id=\"8d3780c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Bisphosphonates and denosumab: what your dentist needs to know<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b4f9103 elementor-widget__width-initial elementor-widget elementor-widget-image\" data-id=\"b4f9103\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"450\" src=\"https:\/\/aclinicadrpedromota.pt\/wp-content\/uploads\/2026\/10\/outubro_2026_Bifosfonatos-e-denosumab-1024x450.webp\" class=\"attachment-large size-large wp-image-24305\" alt=\"bisphosphonates and dentist: woman smiling with a glass of water in hand\" srcset=\"https:\/\/aclinicadrpedromota.pt\/wp-content\/uploads\/2026\/10\/outubro_2026_Bifosfonatos-e-denosumab-1024x450.webp 1024w, https:\/\/aclinicadrpedromota.pt\/wp-content\/uploads\/2026\/10\/outubro_2026_Bifosfonatos-e-denosumab-300x132.webp 300w, https:\/\/aclinicadrpedromota.pt\/wp-content\/uploads\/2026\/10\/outubro_2026_Bifosfonatos-e-denosumab-768x337.webp 768w, https:\/\/aclinicadrpedromota.pt\/wp-content\/uploads\/2026\/10\/outubro_2026_Bifosfonatos-e-denosumab.webp 1366w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-785a59d elementor-widget elementor-widget-text-editor\" data-id=\"785a59d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The consultation went well. He left with a prescription, a date for the first administration and a recommendation I didn\u2019t expect: &#8220;Make an appointment at the dentist before starting.&#8221;<\/p><p>It seems out of place, but there\u2019s a reason. Bisphosphonates and denosumab protect bones and are used in osteoporosis and the follow-up of some cancers, including breast cancer. In rare cases, however, they can affect the way the jaw bone heals after a dental procedure.<\/p><p>In this article about bisphosphonates and dentists, we explain what information should lead to a consultation and what care should be assessed before dental treatments.<\/p><p>Inform the dentist about the medication you are taking or have taken previously. The assessment should consider the drug, reason for prescription, duration of treatment and intended dental procedures.<\/p><p>In this October, Rosa, we answer the most frequent questions they ask us: what is the risk, what should be done first, whether you can treat teeth or put on implants and why you should never stop medication on your own.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c405c81 elementor-toc--minimized-on-tablet elementor-widget elementor-widget-table-of-contents\" data-id=\"c405c81\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;headings_by_tags&quot;:[&quot;h2&quot;,&quot;h3&quot;],&quot;exclude_headings_by_selector&quot;:[],&quot;no_headings_message&quot;:&quot;No headings were found on this page.&quot;,&quot;marker_view&quot;:&quot;numbers&quot;,&quot;minimize_box&quot;:&quot;yes&quot;,&quot;minimized_on&quot;:&quot;tablet&quot;,&quot;hierarchical_view&quot;:&quot;yes&quot;,&quot;min_height&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_tablet&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]},&quot;min_height_mobile&quot;:{&quot;unit&quot;:&quot;px&quot;,&quot;size&quot;:&quot;&quot;,&quot;sizes&quot;:[]}}\" data-widget_type=\"table-of-contents.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-toc__header\">\n\t\t\t<h5 class=\"elementor-toc__header-title\">\n\t\t\t\tContents approached\t\t\t<\/h5>\n\t\t\t\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--expand\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__c405c81\" aria-expanded=\"true\" aria-label=\"Open table of contents\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-down\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M207.029 381.476L12.686 187.132c-9.373-9.373-9.373-24.569 0-33.941l22.667-22.667c9.357-9.357 24.522-9.375 33.901-.04L224 284.505l154.745-154.021c9.379-9.335 24.544-9.317 33.901.04l22.667 22.667c9.373 9.373 9.373 24.569 0 33.941L240.971 381.476c-9.373 9.372-24.569 9.372-33.942 0z\"><\/path><\/svg><\/div>\n\t\t\t\t<div class=\"elementor-toc__toggle-button elementor-toc__toggle-button--collapse\" role=\"button\" tabindex=\"0\" aria-controls=\"elementor-toc__c405c81\" aria-expanded=\"true\" aria-label=\"Close table of contents\"><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-chevron-up\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M240.971 130.524l194.343 194.343c9.373 9.373 9.373 24.569 0 33.941l-22.667 22.667c-9.357 9.357-24.522 9.375-33.901.04L224 227.495 69.255 381.516c-9.379 9.335-24.544 9.317-33.901-.04l-22.667-22.667c-9.373-9.373-9.373-24.569 0-33.941L207.03 130.525c9.372-9.373 24.568-9.373 33.941-.001z\"><\/path><\/svg><\/div>\n\t\t\t\t\t<\/div>\n\t\t<div id=\"elementor-toc__c405c81\" class=\"elementor-toc__body\">\n\t\t\t<div class=\"elementor-toc__spinner-container\">\n\t\t\t\t<svg class=\"elementor-toc__spinner eicon-animation-spin e-font-icon-svg e-eicon-loading\" aria-hidden=\"true\" viewBox=\"0 0 1000 1000\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M500 975V858C696 858 858 696 858 500S696 142 500 142 142 304 142 500H25C25 237 238 25 500 25S975 237 975 500 763 975 500 975Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e493354 elementor-widget elementor-widget-heading\" data-id=\"e493354\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">What are they and why does the dentist come into this story?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-de03b18 elementor-widget elementor-widget-text-editor\" data-id=\"de03b18\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Osteonecrosis of the jaws is rare but severe: an area of the bone becomes exposed in the mouth and heals with difficulty. The risk depends on dose, frequency and duration. In osteoporosis is very low: generally below 0.1% with bisphosphonates and between 0.04% and 0.3% with denosumab. In the oncological schemes it is higher, about 1% in the larger studies, with great variation.<\/p><p>Receiving this medication does not mean, by itself, that the cancer has reached the bones, and the scheme is always decided by the medical team.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-37b1a7e elementor-widget elementor-widget-heading\" data-id=\"37b1a7e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Osteonecrosis of the jaws: what is it and what is the risk?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0f55dc2 elementor-widget elementor-widget-text-editor\" data-id=\"0f55dc2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Let\u2019s move on to the most concerning: osteonecrosis of the jaws. It is a rare but severe injury, in which an area of the bone becomes exposed in the mouth and heals with difficulty, sometimes with pain, swelling, or infection.<\/p><p>The word &#8220;rare&#8221; has numbers. In osteoporosis, estimates are very low: generally below 0.1% with bisphosphonates and between 0.04% and 0.3% with denosumab. In the schemes used in oncology, the risk is higher, about 1% in larger studies, with great variation between studies. In practice, the vast majority of people will never have this problem, but prevention weighs more heavily when doses are higher.<\/p><p>These numbers don\u2019t say what will happen to you, and mouth health also influences the risk. So the right question is not &#8220;will this happen to me?&#8221; but &#8220;what can I do to prevent it from happening?&#8221;<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-55e2490 elementor-widget elementor-widget-heading\" data-id=\"55e2490\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Bisphosphonates and dentist: care before starting medication<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eee3f14 elementor-widget elementor-widget-text-editor\" data-id=\"eee3f14\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The most common answer of international guidelines is simple: a dental evaluation before starting, especially when <a href=\"https:\/\/aclinicadrpedromota.pt\/en\/breast-cancer-and-oral-health-caring-for-the-mouth-during-and-after-cancer\/\" target=\"_blank\" rel=\"noopener\">treatment is oncological,<\/a> with clinical examination and X-rays. The goal is to get to the start of treatment with the mouth in order:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cee5ff9 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"cee5ff9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-arrow-right\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M190.5 66.9l22.2-22.2c9.4-9.4 24.6-9.4 33.9 0L441 239c9.4 9.4 9.4 24.6 0 33.9L246.6 467.3c-9.4 9.4-24.6 9.4-33.9 0l-22.2-22.2c-9.5-9.5-9.3-25 .4-34.3L311.4 296H24c-13.3 0-24-10.7-24-24v-32c0-13.3 10.7-24 24-24h287.4L190.9 101.2c-9.8-9.3-10-24.8-.4-34.3z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Identify problems that should be treated before starting, whenever the state of health allows;<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-arrow-right\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M190.5 66.9l22.2-22.2c9.4-9.4 24.6-9.4 33.9 0L441 239c9.4 9.4 9.4 24.6 0 33.9L246.6 467.3c-9.4 9.4-24.6 9.4-33.9 0l-22.2-22.2c-9.5-9.5-9.3-25 .4-34.3L311.4 296H24c-13.3 0-24-10.7-24-24v-32c0-13.3 10.7-24 24-24h287.4L190.9 101.2c-9.8-9.3-10-24.8-.4-34.3z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Understand which teeth can be maintained and which do not have a good prognosis;<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"https:\/\/aclinicadrpedromota.pt\/en\/its-never-normal-to-bleed-your-gums\/\" target=\"_blank\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-arrow-right\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M190.5 66.9l22.2-22.2c9.4-9.4 24.6-9.4 33.9 0L441 239c9.4 9.4 9.4 24.6 0 33.9L246.6 467.3c-9.4 9.4-24.6 9.4-33.9 0l-22.2-22.2c-9.5-9.5-9.3-25 .4-34.3L311.4 296H24c-13.3 0-24-10.7-24-24v-32c0-13.3 10.7-24 24-24h287.4L190.9 101.2c-9.8-9.3-10-24.8-.4-34.3z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Reduce the likelihood of needing surgery or extractions during treatment;<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-arrow-right\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M190.5 66.9l22.2-22.2c9.4-9.4 24.6-9.4 33.9 0L441 239c9.4 9.4 9.4 24.6 0 33.9L246.6 467.3c-9.4 9.4-24.6 9.4-33.9 0l-22.2-22.2c-9.5-9.5-9.3-25 .4-34.3L311.4 296H24c-13.3 0-24-10.7-24-24v-32c0-13.3 10.7-24 24-24h287.4L190.9 101.2c-9.8-9.3-10-24.8-.4-34.3z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Plan, with the medical team, the healing time when surgery is needed.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a9001a6 elementor-widget elementor-widget-text-editor\" data-id=\"a9001a6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>This does not mean extracting teeth as a precaution; it is what needs treatment and only what does not have a good prognosis. And there is a golden rule: you never postpone oncological treatment on your own initiative to resolve dental issues first. Deadlines are defined by the teams that follow the case, in conjunction with your dentist.<\/p><p>If treatment has already started, it\u2019s not too late. The sooner the mouth is assessed, the better, and regular maintenance with surveillance appointments and professional oral hygiene continues to make a difference.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a8d7552 elementor-widget elementor-widget-heading\" data-id=\"a8d7552\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Can I do extractions or implants?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ad2c578 elementor-widget elementor-widget-heading\" data-id=\"ad2c578\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h4 class=\"elementor-heading-title elementor-size-default\">Bisphosphonates and dental extraction: necessary care<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-96a8b41 elementor-widget elementor-widget-text-editor\" data-id=\"96a8b41\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Can I still go to the dentist? Yes, and you should. Surveillance appointments and cleanings continue to be recommended, and many restorative treatments remain. Not taking care of your mouth does not eliminate the risk: it only makes it more difficult to manage when a problem arises.<\/strong><\/p><p>When we talk about bisphosphonates and dental extraction, it is important to understand what medication takes, why and how long, to assess the care needed in your case. When it is necessary to intervene in the bone, the approach is more conservative: whenever possible, one tries to save the tooth (for example, with endodontic treatment or keeping roots without infection). But an infection or an emergency should not go unanswered for fear. It is up to the dentist to assess the risk and, when necessary, coordinate with the medical team or refer for oral surgery.<\/p><p>The relationship between bisphosphonates and dental implants is not just a &#8220;yes&#8221; or &#8220;no&#8221;: the decision depends on the medication, the reason for treatment, and the clinical evaluation.<\/p><p><strong>And the implants? The answer depends on the treatment. In oncological treatments with high doses, the main international guidelines discourage the placement of implants while they are taking place, except for individual evaluation by a specialist, in conjunction with oncology.<\/strong> In osteoporosis, implants are not contraindicated, but the data is limited: the plan is individualized, with clear information about the risk of osteonecrosis (low) and implant failure, and regular follow-up.<\/p><p>Having completed a treatment phase is not an automatic authorization: the medication history continues to count.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8bcd272 elementor-widget elementor-widget-heading\" data-id=\"8bcd272\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Denosumab and dentist: can I stop the medication?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-98ad4db elementor-widget elementor-widget-text-editor\" data-id=\"98ad4db\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>It is the most natural question, and the answer is: no, on my own initiative. Stopping a drug &#8220;just in case&#8221; seems wise, but the evidence says otherwise.<\/p><p>Bisphosphonates remain in the bone for years, and there is no evidence that a break before dental treatment reduces the risk of osteonecrosis. The available guidelines do not recommend it routinely, and among experts the topic remains under discussion. With denosumab, the problem is another: stopping or delaying treatment in osteoporosis is associated with an increased risk of various vertebral fractures, which can arise in the first few months.<\/p><p>Therefore, do not miss an administration or change the medication to make it coincide with a consultation. In some cases, the prescriber and dentist may agree on the best time for a non-urgent procedure regarding the next administration, but this is always a joint decision.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d1676a7 elementor-widget elementor-widget-heading\" data-id=\"d1676a7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">What to bring to the consultation?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bef3b66 elementor-widget elementor-widget-text-editor\" data-id=\"bef3b66\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Reply &#8220;what are you taking?&#8221; seems easy, until the treatment is an injection given in the hospital every six months, which is not in any box at home. It is the information that is most easily forgotten, and one of the most important.<\/p><p><strong>Take if you can:<\/strong><\/p><ul><li>the name of the medicinal product and dose;<\/li><li>the frequency and dates of administrations;<\/li><li>an indication that you have received this medication in the past, even if treatment has ended or is scheduled to begin;<\/li><li>the list of remaining drugs and the doubts that it has not yet been able to clarify.<\/li><\/ul><p>Finishing treatment does not erase this information: for bisphosphonates, previous use continues to count in the risk assessment.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b1a221d elementor-widget elementor-widget-heading\" data-id=\"b1a221d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">What signs should not wait for the next consultation?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a90f8c4 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"a90f8c4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-list.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-far-hand-point-right\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M428.8 137.6h-86.177a115.52 115.52 0 0 0 2.176-22.4c0-47.914-35.072-83.2-92-83.2-45.314 0-57.002 48.537-75.707 78.784-7.735 12.413-16.994 23.317-25.851 33.253l-.131.146-.129.148C135.662 161.807 127.764 168 120.8 168h-2.679c-5.747-4.952-13.536-8-22.12-8H32c-17.673 0-32 12.894-32 28.8v230.4C0 435.106 14.327 448 32 448h64c8.584 0 16.373-3.048 22.12-8h2.679c28.688 0 67.137 40 127.2 40h21.299c62.542 0 98.8-38.658 99.94-91.145 12.482-17.813 18.491-40.785 15.985-62.791A93.148 93.148 0 0 0 393.152 304H428.8c45.435 0 83.2-37.584 83.2-83.2 0-45.099-38.101-83.2-83.2-83.2zm0 118.4h-91.026c12.837 14.669 14.415 42.825-4.95 61.05 11.227 19.646 1.687 45.624-12.925 53.625 6.524 39.128-10.076 61.325-50.6 61.325H248c-45.491 0-77.21-35.913-120-39.676V215.571c25.239-2.964 42.966-21.222 59.075-39.596 11.275-12.65 21.725-25.3 30.799-39.875C232.355 112.712 244.006 80 252.8 80c23.375 0 44 8.8 44 35.2 0 35.2-26.4 53.075-26.4 70.4h158.4c18.425 0 35.2 16.5 35.2 35.2 0 18.975-16.225 35.2-35.2 35.2zM88 384c0 13.255-10.745 24-24 24s-24-10.745-24-24 10.745-24 24-24 24 10.745 24 24z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">A wound that does not heal, visible bone in the mouth, persistent pain or swelling, pus, teeth swaying without explanation or new numbness should be reported to the dentist and medical staff. Don\u2019t wait for the next routine appointment.<\/span>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c462669 elementor-widget elementor-widget-text-editor\" data-id=\"c462669\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>These signs do not by themselves confirm osteonecrosis: they need evaluation to understand the cause and decide on follow-up. The sooner they are seen, the simpler the answer tends to be.<\/p><p>Ultimately, the goal is not to choose between treating bones and caring for teeth; it is to plan the two together. This October Rosa, the mouth also deserves a place in the plan. If you are about to start, are receiving or have already received biphosphonates or denosumab, share this information with your consultation at A Cl\u00ednica Dr. Pedro Mota in Vila Franca de Xira and bring medication records.<\/p><p>This article is for informational purposes and does not replace an individual clinical evaluation. Do not discontinue or change the medication without a prescription from your doctor.<\/p><p><strong><em>Sources consulted:<\/em><\/strong><\/p><ul><li><a href=\"https:\/\/www.sdcep.org.uk\/media\/xtlp2uqx\/sdcep-mronj-guidance-extant-2024.pdf\" target=\"_blank\" rel=\"noopener\">SDCEP: Oral Health Management of Patients at Risk of Medication-related Osteonecrosis of the Jaw<\/a><\/li><li><a href=\"https:\/\/www.joms.org\/article\/S0278-2391(22)00148-3\/fulltext\" target=\"_blank\" rel=\"noopener\">AAOMS: Position Paper on Medication-Related Osteonecrosis of the Jaw, atualiza\u00e7\u00e3o de 2022<\/a><\/li><li><a href=\"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.19.01186\" target=\"_blank\" rel=\"noopener\">MASCC\/ISOO\/ASCO: Clinical Practice Guideline sobre osteonecrose dos maxilares relacionada com medica\u00e7\u00e3o (2019)<\/a><\/li><li><a href=\"https:\/\/www.ada.org\/resources\/ada-library\/oral-health-topics\/oncology-agents-and-medication-related-osteonecrosis-of-the-jaw\" target=\"_blank\" rel=\"noopener\">American Dental Association: Oncology agents and MRONJ<\/a><\/li><li><a href=\"https:\/\/www.ada.org\/resources\/ada-library\/oral-health-topics\/osteoporosis-medications\" target=\"_blank\" rel=\"noopener\">American Dental Association: Osteoporosis medications and MRONJ<\/a><\/li><li><a href=\"https:\/\/www.gov.uk\/drug-safety-update\/denosumab-60mg-prolia-increased-risk-of-multiple-vertebral-fractures-after-stopping-or-delaying-ongoing-treatment\" target=\"_blank\" rel=\"noopener\">MHRA: Denosumab 60 mg (Prolia), risco de fraturas vertebrais m\u00faltiplas ap\u00f3s suspender ou atrasar o tratamento<\/a><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-c08cb71 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c08cb71\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-d4e6753\" data-id=\"d4e6753\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-59c8548 elementor-align-justify elementor-widget elementor-widget-button\" data-id=\"59c8548\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"#elementor-action%3Aaction%3Dpopup%3Aopen%26settings%3DeyJpZCI6MjIzMjYsInRvZ2dsZSI6ZmFsc2V9\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Schedule a consultation<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-300ea0b\" data-id=\"300ea0b\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-12dc655 elementor-align-justify elementor-widget elementor-widget-button\" data-id=\"12dc655\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"tel:+351913950529\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Call<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-76dd701 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"76dd701\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-4ba6ac7\" data-id=\"4ba6ac7\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c98bc55 elementor-widget elementor-widget-heading\" data-id=\"c98bc55\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Seek expert help<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c11f4a9 elementor-widget elementor-widget-text-editor\" data-id=\"c11f4a9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Will be evaluated by the specialist dentist in our clinic. <strong>We listen to your needs and plan your treatment according to your wishes.<\/strong> In our clinic, we do not sell treatments, we return smiles.<br\/>We plan the smile, clarify your doubts and execute with precision.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-ca9e7c3\" data-id=\"ca9e7c3\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9edee65 elementor-widget elementor-widget-image\" data-id=\"9edee65\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"768\" height=\"512\" src=\"https:\/\/aclinicadrpedromota.pt\/wp-content\/uploads\/2025\/03\/Pedro-primeira-consulta.webp\" class=\"attachment-full size-full wp-image-21084\" alt=\"have questions? our dentist Dr. Pedro Mota answers\" srcset=\"https:\/\/aclinicadrpedromota.pt\/wp-content\/uploads\/2025\/03\/Pedro-primeira-consulta.webp 768w, https:\/\/aclinicadrpedromota.pt\/wp-content\/uploads\/2025\/03\/Pedro-primeira-consulta-300x200.webp 300w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-151aa7d\" data-id=\"151aa7d\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e163e4b elementor-widget elementor-widget-text-editor\" data-id=\"e163e4b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>You may be interested in:<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>The medication is for bones, but it also interests the dentist. This October Rosa, notice the link between bisphosphonates, denosumab and oral health.<\/p>\n","protected":false},"author":2,"featured_media":24305,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_joinchat":[],"footnotes":""},"categories":[125],"tags":[126,127],"class_list":["post-24304","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-posts","tag-oral-health","tag-oral-health-adults"],"_links":{"self":[{"href":"https:\/\/aclinicadrpedromota.pt\/en\/wp-json\/wp\/v2\/posts\/24304","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/aclinicadrpedromota.pt\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/aclinicadrpedromota.pt\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/aclinicadrpedromota.pt\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/aclinicadrpedromota.pt\/en\/wp-json\/wp\/v2\/comments?post=24304"}],"version-history":[{"count":1,"href":"https:\/\/aclinicadrpedromota.pt\/en\/wp-json\/wp\/v2\/posts\/24304\/revisions"}],"predecessor-version":[{"id":24306,"href":"https:\/\/aclinicadrpedromota.pt\/en\/wp-json\/wp\/v2\/posts\/24304\/revisions\/24306"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/aclinicadrpedromota.pt\/en\/wp-json\/wp\/v2\/media\/24305"}],"wp:attachment":[{"href":"https:\/\/aclinicadrpedromota.pt\/en\/wp-json\/wp\/v2\/media?parent=24304"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/aclinicadrpedromota.pt\/en\/wp-json\/wp\/v2\/categories?post=24304"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/aclinicadrpedromota.pt\/en\/wp-json\/wp\/v2\/tags?post=24304"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}