From the Research
It is generally not necessary to discontinue Forteo (Teriparatide) before undergoing dental extractions, as Forteo is a medication used to treat osteoporosis by stimulating bone formation, and unlike bisphosphonates, it does not significantly increase the risk of osteonecrosis of the jaw, which is a rare but serious dental complication. Forteo actually works by promoting bone growth and healing, which could theoretically be beneficial during dental recovery.
Key Considerations
- Inform your dentist about all medications you're taking, including Forteo, before any dental procedure.
- Your dentist and the physician who prescribed Forteo should coordinate care if you have other risk factors or medical conditions that might affect healing.
- If you're concerned about potential interactions or complications, consult with both your prescribing physician and dentist at least a week before the planned extraction to determine if any medication adjustments are needed for your specific situation.
Evidence Summary
The most recent and highest quality study on this topic is from 1, which found that there is low or very low certainty about available evidence on interventions for the prophylaxis or treatment of medication-related osteonecrosis of the jaw (MRONJ). However, another study from 2 found that the risk of ONJ in patients on denosumab for osteoporosis is 2.3%, which is higher than the risk for patients on oral bisphosphonates.
Clinical Implications
- The use of teriparatide, such as Forteo, may actually be beneficial in preventing MRONJ, as it promotes bone growth and healing, as suggested by a study from 3.
- However, it's essential to weigh the benefits and risks of continuing or discontinuing Forteo before dental extractions on a case-by-case basis, taking into account individual patient factors and medical history.
- Coordination of care between the dentist and the physician who prescribed Forteo is crucial to ensure the best possible outcome for the patient.