Yes, Prolia (denosumab) can rarely cause loose teeth, often as a sign of a more serious condition called osteonecrosis of the jaw (ONJ), where jawbone tissue dies. While rare, this risk increases with longer treatment, existing dental issues, or invasive dental procedures, so good oral hygiene, regular dental checkups, and discussing risks with your doctor before starting Prolia are crucial.
Dental side effect of receiving Prolia
Prolia has a side effect in patients who have to have tooth extractions performed. The trauma of the extraction on the bone surrounding the tooth may lead to a condition where the bone dies off, and following the extraction fragments of dead bone are lost from the extraction site.
Osteonecrosis of the Jaw (ONJ): ONJ, which can occur spontaneously, is generally associated with tooth extraction and/or local infection with delayed healing, and has been reported in patients receiving Prolia®. An oral exam should be performed by the prescriber prior to initiation of Prolia®.
Recent research suggests a link between osteoporosis and bone loss in the jaw. When bone loss in the jaw occurs, teeth that are usually supported and anchored by the jawbone may become loose; tooth loss may occur.
Perhaps the most publicized dental complication related to bisphosphonates is osteonecrosis of the jaw. This usually results in an area of exposed bone that will not heal after tooth removal or other oral surgical procedures.
Splinting: The wobbly tooth is cemented to other adjacent teeth to provide additional support as the gums and bone heal. Bone Grafting: Reforms missing front root bone density. Flap Surgery: Assists in eliminating deep tissue bacteria and in healing of gum tissue.
5 to 6 months after your last dose, Prolia has lost its effect of slowing bone turnover. Therefore, it is safe to proceed with surgery on bone (including dental surgery) 6 months after your last dose.
People with ONJ may experience pain, soft tissue swelling and drainage in the mouth, and an exposed jawbone for eight weeks or longer. Other possible signs are bad breath, loose teeth, and signs of infection of the gums.
Effective Sept. 1, 2025, Jubbonti® and Wyost® now replace Prolia® and Xgeva®, respectively, as interchangeable biosimilar products for UnitedHealthcare® Medicare Advantage plans, Medicare Prescription Drug Plan and most employer group Medicare Advantage plans.
Biomarkers cannot determine the risk of developing ONJ. Standard dental procedures such as teeth cleaning, fillings, etc are safe to do when you are on a bisphosphonate or Prolia.
After your treatment with Prolia® is stopped, or if you skip or delay taking a dose, your risk for breaking bones, including bones in your spine, is increased. Your risk for having more than 1 broken bone in your spine is increased if you have already had a broken bone in your spine.
Another common osteoporosis medicine is denosumab (Prolia). Unrelated to bisphosphonates, denosumab might be used in people who can't take a bisphosphonate or did not tolerate one, such as some people with reduced kidney function. Denosumab is delivered by injections, just under the skin, every six months.
There is no recommended time of treatment for Prolia Injections; clinical studies have often been three years, and at least one study went for 8 years. The longer you take Prolia Injection, the bigger the improvement in fracture risk when compared to placebo.
Prolia is only available as a subcutaneous injection. Fosamax is often a first-choice medication for osteoporosis. But when comparing Boniva versus Fosamax, Boniva doesn't have to be taken as often. And when comparing Prolia versus Fosamax, Prolia may be preferred for people who are at very high risk for fracture.
Prolia® can cause your hair to get thinner. If you notice this, tell your nurses or pharmacist.
Can doctors treat osteonecrosis of the jaw? While there is no specific treatment for ONJ, it can heal on its own with the help of antibiotic rinses and avoiding any other dental surgery. But healing is not guaranteed.
When a person starts to notice changes in their gums, loose teeth, or difficulty with their dentures, it could be a sign that the jawbone is deteriorating. Your jawbone is the foundation that supports your teeth and maintains the shape of your lower face.
Denosumab has a higher risk of jaw osteonecrosis
They found 639 people with breast cancer that had spread to the bone and who had received denosumab, a bisphosphonate, or both medicines. Both types of drugs were taken once per month. Overall, 56, or 9%, of these patients developed ONJ, the researchers found.
Dental and teeth-related side effects
Symptoms of dental or teeth-related side effects may include loose teeth and mouth pain. In rare cases, teeth-related side effects may be a symptom of jaw necrosis, which is another side effect of Prolia.
How Long Does It Stay in Your System? Prolia takes about 4 to 5 months to leave your system. If you could become pregnant while on Prolia, you must use birth control during treatment and for 5 months after the last dose of Prolia. Keep in mind once you stop Prolia, your risk for bone fractures increases.
Prolia and Dental Implants
That doesn't mean you can't get dental implants while on Prolia — many patients do successfully. But it requires coordination between your oral surgeon and your physician to minimize risks and ensure optimal timing of your treatment.
Splinting. If your loose tooth hasn't pulled away from your gums, splinting may help. During this procedure, a dentist bonds (glues) two neighboring teeth together. This can give your loose tooth additional support and keep it from moving while it heals.
It is normal for healthy teeth to have slight mobility when eating something. However, if someone has considerably mobile teeth during eating, it indicates an underlying issue. In most cases, teeth feel loose during eating as a result of underlying gum disease.
Bone loss and osteoporosis
About 10 million Americans have osteoporosis and another 44 million have low bone density. Overall, this issue affects women more than men. In either sex, the bone loss can affect the jawbone, causing teeth to loosen.