Why medications matter
Some medications are linked to implant failure or to jawbone complications.23 AAOMS describes sharing a full medical history before surgery as important.1
Bone-strengthening drugs (antiresorptives)
Bisphosphonates and denosumab are antiresorptive drugs used for osteoporosis and in cancer care.2 A rare side effect is medication-related osteonecrosis of the jaw (MRONJ), in which exposed jawbone persists for more than eight weeks.2 The American Association of Oral and Maxillofacial Surgeons updated its position paper on MRONJ in 2022.2
| Group | AAOMS 2022 position |
|---|---|
| Osteoporosis, bisphosphonates | Estimated MRONJ risk 0.02 to 0.04 percent2 |
| Osteoporosis, denosumab | Estimated MRONJ risk 0.3 percent2 |
| Osteoporosis, implant planned | Informed consent covering the low MRONJ risk and early and late implant failure, then long-term recall2 |
| Cancer patients on injected antiresorptive or antiangiogenic drugs | Implant placement should be avoided2 |
AAOMS states that strong data are lacking and available data conflict for osteoporosis patients receiving implants.2 The ITI Group 1 consensus (2018) found that bisphosphonates taken for osteoporosis were not associated with increased implant failure.3
Antidepressants and acid reducers
The ITI Group 1 consensus (2018) found that certain selective serotonin reuptake inhibitors (SSRIs, a class of antidepressants) and proton pump inhibitors (PPIs, a class of acid reducers) were associated with a statistically significant increase in implant failure.3
Antibiotics
A single dose of antibiotic before surgery reduced early implant failures in randomized trials; see the antibiotics topic.4
Questions to ask
- Bring a full list of medications, including any past bone-strengthening drugs and how long they were taken.
- Ask whether the prescribing physician needs to be consulted.
- Ask how the medication changes the plan or the follow-up schedule.
Do not stop or change any prescribed medication without talking to the prescribing physician.
General information about dental implants. Treatment decisions are made with a licensed dentist.
Sources
- AAOMS (MyOMS.org): Anesthesia for Oral and Maxillofacial Surgery. myoms.org
- AAOMS Position Paper: Medication-Related Osteonecrosis of the Jaw, 2022 Update. aaoms.org
- Jung RE et al. Group 1 ITI Consensus Report: implant length, design and medications. Clin Oral Implants Res 2018. pubmed.ncbi.nlm.nih.gov
- Esposito MA et al. Antibiotic prophylaxis for dental implant placement. Cochrane Database Syst Rev 2026. pubmed.ncbi.nlm.nih.gov
