Yes, most patients with osteoporosis can safely receive dental implants. The condition itself rarely disqualifies you. What matters more is your jawbone volume and any bone-density medications you take. At Inspire Dental in Tigard, we use 3D CBCT imaging, coordinate with your physician, and plan surgery to give you the same high success rates as other patients.

We hear this question often. A retired teacher from Summerfield came in last fall after her primary care doctor told her she had osteoporosis and started her on Fosamax. She had been missing a molar for two years and assumed implants were off the table. They weren't. Six months later, she was chewing comfortably again.

Here is what every patient on Pacific Highway 99W should know before assuming osteoporosis ends the conversation.

Does osteoporosis automatically rule out dental implants?

No. Osteoporosis affects skeletal bone, but jawbone behaves differently than the hip or spine in many patients. We evaluate your jaw independently with cone beam CT imaging, which measures the density and volume right where the implant will go. According to peer-reviewed dental literature, several systematic reviews have found that implant survival rates in patients with osteoporosis are comparable to those without the condition when treatment is properly planned.

That's the part most people miss. A DEXA scan tells us about your hips. A CBCT tells us about your jaw. The two can look very different.

What actually matters during candidacy review:

• Volume of bone at the planned implant site

• Density readings from the CBCT

• Medications you take and how long you've been on them

• Overall medical history and healing factors

How do osteoporosis medications affect implant healing?

This is where the conversation gets specific. Bone-density medications carry a small risk of medication-related osteonecrosis of the jaw, or MRONJ. The risk is not equal across drugs.

Oral bisphosphonates (Fosamax/alendronate, Boniva/ibandronate, Actonel/risedronate) carry a low risk. Per the American Association of Oral and Maxillofacial Surgeons (AAOMS) position paper on MRONJ, incidence in patients taking oral bisphosphonates for osteoporosis who undergo dental implant placement is reported at well under 1% in most studies.

IV bisphosphonates used in cancer treatment carry substantially higher risk. AAOMS guidance treats these patients very differently.

Newer antiresorptives like denosumab (Prolia) and romosozumab also factor in. AAOMS recognizes denosumab as associated with MRONJ risk separate from bisphosphonates, so we ask about it directly.

Duration matters. Most guidance from AAOMS and the ADA notes increased concern after roughly four years of continuous oral bisphosphonate use. Under that threshold, risk stays very low.

For some patients, a drug holiday makes sense. We never make that call alone. We coordinate with your prescribing physician, whether that's your primary care doctor in Tigard or a rheumatologist you see in Tualatin.

What additional planning happens for patients with osteoporosis?

More imaging. More coordination. A slower, more conservative surgical approach.

Every patient gets a CBCT scan to map bone density and volume at the exact implant site. We review your full medication list, including start dates. If you've been on Prolia or Fosamax for years, we want to know that before we plan anything. We reach out to your prescribing physician to align on timing.

If ridge volume is low, bone grafting may come first. That's true for many patients, not just those with osteoporosis. Grafting in the jaw heals predictably even in osteoporotic patients when planned carefully.

During surgery, we use a conservative technique that minimizes trauma to surrounding bone. We also extend healing checkpoints. Where another patient might be cleared at three months, we may wait four or five and verify osseointegration with a follow-up image.

Slow and steady. That's the whole trick.

What does the research say about success rates?

Encouraging. Multiple systematic reviews published in journals like the Journal of Clinical Periodontology have shown implant survival rates in osteoporotic patients are similar to the general population. MRONJ rates with oral bisphosphonates and implants stay well under 1% in most published studies per AAOMS guidance.

Healing may take a little longer. Long-term maintenance becomes more important. We ask osteoporosis patients to keep recare cleanings on schedule and to call us at the first sign of gum tenderness or change around an implant. Early attention prevents almost every complication we see.

What to bring to your implant consultation in Tigard

If you're driving down 99W from King City or Bull Mountain for a consult, bring these:

• A complete list of medications, including start dates for any bone-density drugs

• Your most recent DEXA scan results if you have them

• Contact information for your prescribing physician

• Questions about timing, possible drug holidays, and alternatives like bridges

We'll handle the CBCT in-office. We'll handle the physician outreach. You bring the history, we build the plan.

A DEXA scan tells us about your hips. A CBCT tells us about your jaw. The two can look very different.

Frequently Asked Questions

Can I get a dental implant if I take Fosamax or Boniva?

In most cases, yes. Oral bisphosphonates carry a low MRONJ risk, and AAOMS data shows incidence well under 1% in osteoporosis patients receiving implants. We review your duration of use, coordinate with your prescriber, and may discuss a drug holiday if you've been on the medication for more than about four years.

Should I stop my osteoporosis medication before implant surgery?

Never stop on your own. The decision belongs to your prescribing physician, not your dentist. We share our surgical plan with them, and together we decide whether a drug holiday is appropriate. For most osteoporosis patients on oral bisphosphonates short-term, no holiday is needed.

How long do implants last in patients with osteoporosis?

Long-term survival rates are comparable to patients without osteoporosis, according to multiple systematic reviews. With consistent home care and regular cleanings at our Tigard office, many patients enjoy their implants for decades. Maintenance becomes the most important variable over time.

Is bone grafting more likely if I have osteoporosis?

Not necessarily. Grafting depends on the volume of bone at the implant site, not your DEXA score. The CBCT scan tells us whether grafting is needed. Many osteoporosis patients have plenty of jawbone and skip grafting entirely.

What is MRONJ and how rare is it?

MRONJ stands for medication-related osteonecrosis of the jaw, a rare condition where bone fails to heal after a dental procedure. For osteoporosis patients on oral bisphosphonates, AAOMS data places the risk well under 1%. The risk is much higher for cancer patients on IV bisphosphonates, which is a different clinical situation.

Ready to talk about implants?

If you've been told you can't have implants because of osteoporosis, we'd like to take another look. Call Inspire Dental in Tigard at (503) 639-4330 to schedule a consultation. We'll review your medications, image your jaw, and give you a straight answer about your candidacy.