Bisphosphonates and Dental Treatment: Alendronic Acid, Prolia and Your Jaw (2026 UK Guide)

Last updated: October 2026. Sources: NHS.uk, the Medicines and Healthcare products Regulatory Agency (MHRA) on GOV.UK, the NHS Business Services Authority (NHSBSA), the British National Formulary (BNF) and NICE Clinical Knowledge Summaries, the Scottish Dental Clinical Effectiveness Programme (SDCEP), NHS inform, GOV.WALES, the HSC Business Services Organisation (Northern Ireland) and NHS trust patient information. All guidance, risk figures and charges verified on 16 October 2026.

TL;DR Yes, you can usually have dental treatment while taking bisphosphonates such as alendronic acid, or denosumab (Prolia). Check-ups, cleaning and fillings carry little or no extra risk. Tooth extractions and implants carry a small risk of a rare jaw condition, so always tell your dentist about your medicine and never stop taking it without your prescriber's advice.

If you have been prescribed alendronic acid, Prolia or another medicine to strengthen your bones, you may have read that it can affect your jaw. That can be worrying when you need a filling, a tooth out or a new denture. The good news is that the risk is small, most dental care carries on as normal, and there is clear UK guidance on what your dentist should do.

Osteoporosis medicines are very widely used. NICE Clinical Knowledge Summaries (CKS) note that the prevalence of osteoporosis in women "increases markedly, from approximately 2% at 50 years of age to almost 50% at 80 years of age", and that "In England and Wales, more than 2 million women have osteoporosis." [1] Many of them will need dental treatment while taking a bone-strengthening medicine.

This guide explains which medicines are involved, how small the risk really is, what happens before and during treatment, and what you will pay on the NHS in each UK nation. It draws on NHS.uk, safety advice from the MHRA, and guidance for dentists from the Scottish Dental Clinical Effectiveness Programme (SDCEP), part of NHS Education for Scotland, which was published in March 2017 and reviewed and confirmed as current in March 2024 [2]. It is general information, not personal medical advice, so always talk to your dentist and the doctor who prescribes your medicine.

The short answer: dental treatment on osteoporosis medicines

Most people taking an osteoporosis medicine can have dental treatment in the normal way at their usual practice. SDCEP's guidance tells dentists to "Carry out all routine dental treatment as normal and continue to provide personalised preventive advice in primary care" [3]. Its leaflet for patients puts the risk in plain terms:

"The risk is very low to non-existent for most ordinary treatments. The risk is increased if you require treatment that affects bone (like a tooth extraction or dental implants) but is still considered low." [4]

The one thing you must do is tell your dentist. NHS.uk says: "Tell your dentist you're taking alendronic acid. They may recommend a different type of dental treatment." [5] The same applies to any bone-strengthening medicine, including injections and drips you have in hospital.

Which osteoporosis medicines affect the jaw

The medicines linked to jaw problems are called anti-resorptive drugs because they slow down the natural breakdown of bone. They include the bisphosphonates and denosumab. SDCEP's patient leaflet explains that denosumab (Prolia) "acts differently to the bisphosphonates but is also associated with MRONJ", the jaw condition described in the next section [4].

The table below lists the medicines on SDCEP's list of drugs with an MHRA safety update for this side effect, with the brand names SDCEP gives [6] and the usual doses from the British National Formulary (BNF) and NHS.uk.

SDCEP's list also includes pamidronate (Aredia), used for Paget's disease, bone pain and cancer, and sodium clodronate (Bonefos, Clasteon, Loron), used for bone pain and cancer [6].

A few related points are worth knowing:

• Calcium and vitamin D are not a risk on their own. SDCEP says "patients taking calcium or vitamin D supplements only are not considered to be at risk of MRONJ." [13]
• Romosozumab is another osteoporosis injection listed on NHS.uk [14]. SDCEP's 2024 update lists it among drugs with only a possible link to jaw problems, says the evidence is of "very low certainty", and says there is not enough evidence to estimate the risk [15].
• Some cancer medicines that are not bone drugs, such as bevacizumab, sunitinib and aflibercept, are also on SDCEP's list [6]. If you take one of these, your cancer team and dentist will advise you, and the cancer-related guidance below applies.

If you are not sure which medicine you take, check the box or your repeat prescription, or ask your pharmacist.

What medication-related osteonecrosis of the jaw (MRONJ) is

Medication-related osteonecrosis of the jaw (MRONJ) is a rare side effect in which an area of jaw bone becomes exposed in the mouth and does not heal. NHS.uk explains that "In osteonecrosis, the cells in the jaw bone die, which can lead to problems with healing." [14]

Dentists use a precise definition. SDCEP describes MRONJ as "exposed bone, or bone that can be probed through an intraoral or extraoral fistula, in the maxillofacial region that has persisted for more than eight weeks" in someone who has taken one of these medicines, "and where there has been no history of radiation therapy to the jaw" [13]. In plain English, that means bone showing in the mouth for more than 8 weeks, in a person who has never had radiotherapy to the jaw.

Dental treatment can trigger MRONJ, but it is not the underlying cause. SDCEP says that "although invasive dental treatment is a risk factor, it does not cause the disease." [13] It notes that MRONJ "can occur 'spontaneously' without the patient having undergone any recent invasive dental treatment", and that a recent tooth extraction was seen in around 60% of people who develop it [13]. That is why good everyday dental health, and not just careful extractions, matters.

If MRONJ does develop, it is treated by hospital specialists. SDCEP's patient leaflet says that where only a small amount of bone is exposed, "treatment may be with antibiotics or antibacterial mouth rinses. In cases where more bone is exposed, some surgery may be required." [4]

How small the risk is: osteoporosis doses vs cancer doses

The risk of MRONJ for people taking these medicines for osteoporosis is low. SDCEP's patient leaflet states:

"For patients taking anti-resorptive drugs for the treatment of osteoporosis, the risk of developing this side effect is between 1 in 1000 and 1 in 10,000." [4]

SDCEP's 2024 update reviewed newer studies, which give slightly different figures for bisphosphonates and denosumab (see the table below), and notes that "the variation between studies makes it difficult to determine accurate estimates." [15] No single exact figure exists, but every estimate puts the risk for osteoporosis treatment well below 1 in 100.

The risk is much higher for people having these medicines at high doses for cancer. The MHRA says: "In patients treated for osteoporosis (regardless of route of administration), the risk of ONJ is small compared with that in patients treated with the higher doses used for cancer-related conditions." [16] NHS.uk makes the same point, describing osteonecrosis of the jaw as linked "most frequently with high-dose intravenous bisphosphonate treatment for cancer and not for osteoporosis." [14]

Having a tooth out raises the risk, but for osteoporosis patients it stays low. SDCEP's guidance cites a systematic review estimating "that the incidence of MRONJ after tooth extraction is 2.9% in patients with cancer and 0.15% in patients being treated for osteoporosis" [13]. That is roughly 15 in every 10,000 osteoporosis patients who have an extraction.

The type of medicine matters too. The Medicines and Healthcare products Regulatory Agency (MHRA) lists drug potency, with a higher risk for "highly potent compounds such as zoledronate, pamidronate and denosumab", the route (injections and drips carry more risk than tablets) and the total dose taken over time as risk factors [16].

Low risk and higher risk: how your dentist assesses you

Dentists following SDCEP guidance place patients taking these medicines into a low risk or higher risk group, and plan treatment accordingly [13] [3].

You are usually in the low risk group if you take a medicine for osteoporosis (or another non-cancer bone condition such as Paget's disease) and are not also taking long-term steroid medicine, and:

• you have taken bisphosphonate tablets for less than 5 years, or
• you have had bisphosphonate drips every 3 months or once a year for less than 5 years, or
• you have denosumab (Prolia) injections [13].

You are usually in the higher risk group if:

• you have taken bisphosphonates for osteoporosis for more than 5 years
• you take bisphosphonates or denosumab for any length of time together with steroid medicine taken by mouth or injection (systemic glucocorticoids)
• you are having these drugs, or anti-angiogenic drugs, as part of cancer treatment
• you have had MRONJ before [13]

Two rules about past treatment often surprise people. SDCEP says that "Patients who have taken bisphosphonate drugs at any time in the past and those who have taken denosumab in the last nine months are allocated to a risk group as if they are still taking the drug." [13] This is because bisphosphonates stay in the bone for years.

Being in the higher risk group does not mean your risk is the same as a cancer patient's. SDCEP explains that grouping these patients together "does not imply that both groups have the same absolute risk level. It simply reflects the need for more considered treatment planning in these higher risk groups." [13]

Steroids are included because some studies link long-term use with a higher risk, although SDCEP notes "the association has not been observed in other studies." [13] Tell your dentist if you take steroid tablets or injections, and how long you have been on your bone medicine.

Before you start: why a dental check-up comes first

Seeing a dentist before you start an osteoporosis medicine is the most useful thing you can do to protect your jaw. NHS.uk advises people on alendronic acid to "keep your teeth clean and have a dental check-up every 6 months", adding that "your doctor may also recommend a dental check-up before you start your treatment" [5]. Its osteoporosis page says that "If you have a history of dental problems, you may need a check-up before you start treatment with bisphosphonates." [14]

The aim is to deal with problems early, while the risk is lowest. SDCEP tells dentists to "aim to get the patient as dentally fit as feasible, prioritising preventive care" before treatment starts, or as soon as possible afterwards [3]. In practice, your dentist may:

• take out any teeth that are unlikely to last, without delay
• treat gum disease and infection
• adjust or replace dentures that rub or fit poorly
• prescribe a high fluoride toothpaste [3]

SDCEP describes this as a way to "future-proof" your oral health so that you are less likely to need an extraction later [13]. The MHRA also asks doctors starting someone on denosumab or a bisphosphonate drip to advise them to report any mouth or teeth problems first, to make sure dentures fit, and to "maintain good oral hygiene and get routine dental check-ups during treatment" [16].

Patient reminder cards

If you are prescribed denosumab (Prolia or Xgeva) or a bisphosphonate given into a vein, such as zoledronic acid (Aclasta) or intravenous ibandronic acid, you should be given a patient reminder card explaining the jaw risk [16] [12]. The MHRA introduced these cards "for denosumab and intravenous bisphosphonates" [16], so the scheme does not cover bisphosphonate tablets such as alendronic acid. If you take tablets, it is up to you to tell your dentist. If you do have a card, show it at every dental appointment.

If you are struggling to find an NHS dentist before your treatment starts, tell your GP or specialist. Our guide to finding an NHS dentist accepting new patients has practical steps for getting seen.

Routine dental care while you are on treatment

Everyday dental treatment carries on as normal while you take an osteoporosis medicine. SDCEP's guidance for dentists says to "Treat routinely for scale and polish, simple restorations, recall and radiological review." [3] In other words, check-ups, X-rays, cleaning by a dentist or hygienist and fillings go ahead in the usual way.

Regular check-ups matter even when nothing hurts. SDCEP points out that "some patients may be asymptomatic at presentation, with MRONJ lesions an incidental finding" at a routine appointment [13]. Its patient leaflet asks you to "Visit your dentist for regular dental check-ups" so that "any dental disease that may develop is treated before dental surgery is required." [4] Our guide to how often you should have a dental check-up explains how your dentist sets the gap between visits.

Keep your dentist's record of your medicines up to date. NHS.uk explains that at a check-up the dental team may ask "about your general health, and if you take any medicines" [17], and in Scotland NHS inform asks patients to "bring an up-to-date list of all medicines" [18]. SDCEP's leaflet asks you to tell your dentist "about any health problems that you have and all medicines that you are taking so that the dentist can assess your individual risk for developing MRONJ." [4]

Looking after your mouth at home lowers your risk further. SDCEP's leaflet recommends cleaning your teeth "regularly and carefully", stopping smoking, cutting down on sugary snacks and drinks, and reducing alcohol [4]. If you have diabetes as well as osteoporosis, our guide to dental care for diabetics covers the extra gum care that helps.

If you need a tooth out: what your dentist will do

A tooth extraction is the treatment most likely to trigger MRONJ, but for most people taking osteoporosis medicines it can still be done safely at their usual practice. For patients in the low risk group, SDCEP's guidance tells dentists to "Perform straightforward extractions and procedures that may impact on bone in primary care." [3] Primary care means your normal high street dental practice rather than a hospital.

Before the extraction, your dentist should discuss the risks of the procedure with you "to ensure valid consent", then follow the approach for your risk group [3]. Not treating a problem tooth has its own risks: SDCEP's leaflet notes that you "may be at increased risk of developing other health problems if a dental disease is not treated." [4]

If you are in the higher risk group, your dentist will take a more cautious approach first. SDCEP advises dentists to "Explore all possible alternatives to extraction where teeth could potentially be retained e.g. retaining roots in absence of infection. If extraction remains the most appropriate treatment, proceed as for low risk patients." [3] Specialist advice is reserved for "medically complex patients for whom you would normally seek advice, including higher risk patients who are being treated with anti-resorptive or anti-angiogenic drugs for the management of cancer" [3].

You will not usually be given antibiotics or an antiseptic mouthwash just because of your bone medicine. SDCEP tells dentists: "Do not prescribe antibiotic or antiseptic prophylaxis following extractions or other bone-impacting treatments specifically to reduce the risk of MRONJ." [3] Your dentist may still prescribe them if they are needed for another clinical reason, such as an existing infection.

Expect a follow-up appointment to check healing. SDCEP advises dentists to tell patients "that they will be asked to return after 8 weeks so that you can ensure the extraction socket has healed adequately." [13] If the socket has not healed at 8 weeks and MRONJ is suspected, your dentist will refer you to an oral surgery or special care dentistry specialist [3]. In the meantime, SDCEP asks dentists to advise patients to contact the practice about "unexpected pain, tingling, numbness, altered sensation or swelling in the extraction area" [3].

For what an extraction costs on the NHS and privately, see our guide to tooth extraction costs in the UK.

Should you stop your medicine before dental work

No. You should not stop or delay an osteoporosis medicine because you need dental treatment, unless the doctor who prescribes it tells you to. SDCEP's patient leaflet answers the question directly:

"No, continue to take your medication. The medical benefits are likely to far outweigh the risks. Talk with your doctor and dentist if you have any questions." [4]

Stopping a bisphosphonate for a short time is unlikely to help your jaw anyway. SDCEP's guidance for dentists says "There is no evidence that MRONJ risk will be reduced if the patient temporarily, or even permanently, stops taking bisphosphonate drugs prior to invasive dental procedures since the drugs may persist in the skeletal tissue for years." [13] It adds that any break in treatment "is the responsibility of the prescribing physician and dental practitioners should not discourage patients from continuing with their medication." [13]

Your doctor reviews your treatment in any case. NHS.uk says that for alendronic acid, "your doctor will look at the benefits and risks of your treatment after 3 to 5 years", and warns that "By not taking alendronic acid, you're more likely to break a bone." [5]

Why denosumab (Prolia) injections must not be missed

Stopping or delaying denosumab carries a particular risk to your spine. The MHRA has warned of "an increased risk of multiple vertebral fractures" in patients "within 18 months of stopping or delaying ongoing denosumab 60mg treatment for osteoporosis", and says "patients should not stop denosumab without specialist review" [19]. It reported 44 UK cases of vertebral fracture after stopping or delaying Prolia between 2015 and June 2020, some described as life-changing [19].

If you do miss a dose, the MHRA says "the missed injection should be administered as soon as possible" [19]. An NHS trust leaflet explains that the effects of denosumab "wear off quickly, 6 months after your most recent injection", which "is why it is important that doses are not missed or significantly delayed." [20]

There is one situation where timing can be coordinated. For people on six-monthly Prolia injections, SDCEP says an acceptable option is to delay non-urgent invasive dental treatment on a tooth without symptoms "until the month prior to the patient's next scheduled drug administration", with the next injection given once the area has healed, and that this needs close liaison between the dentist and the prescriber [13]. This is a decision for your dentist and doctor together. Never move, skip or delay an injection yourself.

Dental implants and dentures on osteoporosis medicines

Dental implants are not ruled out if you take an osteoporosis medicine, but they do carry a small extra risk. SDCEP's guidance states that "Implant placement is not currently contraindicated in patients with osteoporosis", and that implant failure rates "appear similar to those in patients with no history of bisphosphonate use" [13]. However, MRONJ has been reported around implants. SDCEP says the overall risk "appears to be low", and that reports are less frequent where implants were placed before bisphosphonate treatment began [13].

If you are considering implants, your dentist should explain "the risk of compromised bone healing and MRONJ following the procedure and the additional small risk of long-term implant failure" [13]. SDCEP notes that "There is no data on implant survival in patients treated with denosumab." [13] NHS.uk says that if you have implants placed while taking alendronic acid, "there's a very small chance of damage to your jawbone." [5]

The position is different for cancer treatment. SDCEP says it "is generally agreed that implant placement should be avoided in patients who are being treated with high dose anti-resorptive or anti-angiogenic drugs for the management of cancer." [13] If you already had implants before starting a bone medicine, your dentist should tell you about "the small risk of spontaneous MRONJ at those sites" [13], so keep them very clean and keep up your check-ups.

Implants are usually a private treatment. NHS.uk says "Implants are usually only available privately and are expensive", although they are sometimes available on the NHS for people who cannot wear dentures for reasons such as mouth cancer or an accident [21]. Our guides to dental implant costs and implants versus dentures compare the options.

Dentures

Well-fitting dentures matter more when you take a bone medicine. SDCEP lists "mucosal trauma from ill-fitting dentures or other appliances" as a risk factor for MRONJ [13], and the MHRA advises people starting denosumab or a bisphosphonate drip to "make sure their dentures fit properly before starting treatment" [16]. If a denture rubs or causes a sore that does not heal, see your dentist rather than putting up with it.

On the NHS in England, dentures are a Band 3 treatment [22], and denture repairs are free [23]. Our guide to NHS and private denture costs has the full price breakdown.

Warning signs to report to your dentist and doctor

Contact your dentist straight away if you notice any of these symptoms while taking, or after taking, an osteoporosis medicine. SDCEP's patient leaflet lists:

• a feeling of tingling, numbness, heaviness or other unusual sensations in your jaw
• pain in your jaw or a bad taste
• swelling of your jaw
• pus or discharge
• loose teeth
• exposed bone in your jaw [4]

NHS.uk lists "a loose tooth, mouth sores, or swelling or pain in your mouth or jaw" among the rare serious side effects of alendronic acid, and says to "contact your dentist as well as your doctor, as this could be a sign of damage to your jawbone" [24]. It advises calling a doctor or NHS 111 straight away if you have these symptoms [24]. The MHRA also mentions "non-healing sores or discharge" as symptoms to report [16].

Many of these signs have more common causes, such as a gum infection or an ulcer, but only a dentist can tell the difference. Our guides to mouth ulcers that will not heal and getting urgent dental care explain where to go if you cannot get an appointment with your own dentist.

NHS dental costs across the UK and who gets free treatment

Taking an osteoporosis medicine does not change what you pay for NHS dental treatment. The charges and exemptions are the same as for anyone else, and they differ between the four UK nations.

England

NHS dental treatment in England is charged in three bands. These charges apply from 1 April 2026 [23] [25] [26]:

You pay one charge for a course of treatment, even if it takes several visits [25]. NHS.uk also says that if you "need further treatment within 2 months, you do not have to pay extra if the further treatment is included in the same band, or a lower band." [23] Our guide to NHS dental charges in 2026 explains the bands in full.

Wales

Wales uses a care-package system rather than bands. The Welsh Government says "There is a maximum total charge of £384 for a course of treatment" [27]. Dental examinations are free for people "aged under 25" and "aged 60 or over", but if the examination leads to further treatment, such as an X-ray, you pay the full examination charge [27]. A simple restorative care package costs £36.03 and "Includes fillings, temporary crowns, Hall crowns and extractions for up to a total of 4 teeth." [27]

Scotland

In Scotland, NHS inform says "Everyone in Scotland is entitled to free NHS dental examinations". Adults who pay "pay 80% of the treatment costs", capped "at a maximum of £384 per course of treatment", and NHS treatment is free for everyone aged under 26 [18].

Northern Ireland

The HSC Business Services Organisation states that patients pay "80% of the gross cost of the treatments up to a maximum of £384", a figure it dates to 1 April 2007, so check current charges with your practice [28]. Denture repairs are free for all patients [28].

Who gets free NHS dental treatment in England

In England, you get free NHS dental treatment if, when your treatment starts, you are:

• under 18, or under 19 and in full-time education
• pregnant, or have had a baby in the last 12 months
• having treatment in an NHS hospital from a hospital dentist (you may still pay for dentures or bridges)
• getting Income-related Employment and Support Allowance or Pension Credit Guarantee Credit
• getting Universal Credit, if your income is below a certain amount
• named on a valid HC2 certificate under the NHS Low Income Scheme [29] [30]

Three points often catch out people who take osteoporosis medicines:

• Being 60 or over does not give free dental treatment in England. It gives free prescriptions and sight tests, but the NHSBSA's list of who gets free dental treatment does not include age 60 [26].
• A medical exemption certificate does not cover dental charges. The NHSBSA says "A medical exemption certificate does not exempt you from other NHS charges including dental treatment or glasses." [31]
• Pension Credit Savings Credit on its own does not count. The NHSBSA says "If you get Pension Credit Savings Credit on its own, you are not automatically entitled to free NHS dental treatment." [30]

If you are on a low income, you may still get help with part of the cost through an HC3 certificate [29]. Our free NHS dental treatment eligibility guide covers every route, including the rules in Scotland, Wales and Northern Ireland. Private practices set their own fees, and our guide to private dentist prices shows typical costs.

Frequently asked questions

Can I have a tooth out if I take alendronic acid?

Yes. Most people taking alendronic acid for osteoporosis can have a tooth out at their usual dental practice. SDCEP guidance tells dentists to carry out straightforward extractions in low risk patients in primary care, then check healing after 8 weeks [3] [13]. Tell your dentist about your medicine first, as they may suggest a different treatment [5].

Do I need to tell my dentist I take alendronic acid?

Yes. NHS.uk says "Tell your dentist you're taking alendronic acid. They may recommend a different type of dental treatment." [5] Tell them how long you have taken it and whether you also take steroids, because SDCEP uses both to decide your risk level [13]. The same applies to Prolia injections and bisphosphonate drips.

Should I stop alendronic acid before dental treatment?

No. SDCEP's patient leaflet says "No, continue to take your medication. The medical benefits are likely to far outweigh the risks." [4] Bisphosphonates stay in the bone for years, so a short break is not shown to lower the jaw risk [13]. Only the doctor who prescribes your medicine should decide whether you pause or stop it.

Can I have dental implants if I take bisphosphonates?

Usually yes, if you take them for osteoporosis. SDCEP says implant placement "is not currently contraindicated in patients with osteoporosis", although there is a small risk of jaw problems and of the implant failing in the long term [13]. Implants are generally avoided during high-dose cancer treatment, so discuss your full medical history with your dentist first.

Is Prolia (denosumab) a problem for dental work?

Prolia, like bisphosphonates, carries a small risk of jaw problems, so tell your dentist you have the injections [4]. Routine treatment goes ahead as normal. Never miss or delay an injection to fit around dental work: the MHRA warns that stopping or delaying denosumab can cause spinal fractures, and any timing change needs your dentist and doctor to agree [19] [13].

What are the symptoms of osteonecrosis of the jaw?

Symptoms include tingling, numbness or heaviness in the jaw, jaw pain or a bad taste, swelling, pus or discharge, loose teeth and exposed bone in the mouth [4]. NHS.uk says to contact your dentist as well as your doctor if you have a loose tooth, mouth sores, or pain or swelling in your mouth or jaw [24].

How long after stopping bisphosphonates is the jaw risk still there?

The risk can last for years after stopping bisphosphonates, because the drugs stay in the bone. SDCEP guidance tells dentists to treat anyone who has taken a bisphosphonate at any time in the past, or denosumab in the last 9 months, as if they are still taking it [13]. Always mention past bone medicines to your dentist.

Is dental treatment free if I take osteoporosis medicine?

Not automatically. Taking an osteoporosis medicine does not give free NHS dental treatment, and a medical exemption certificate does not cover dental charges [31]. In England, being 60 or over gives free prescriptions but not free dental treatment [26]. You may qualify through benefits, an HC2 certificate or, in Scotland, being under 26 [29] [18].

Finding a dentist before you start treatment

A dental check-up before you start an osteoporosis medicine, and regular check-ups while you take it, are the simplest ways to keep the small risk of jaw problems as low as possible. We know that finding an NHS practice with space for new patients can be difficult in many parts of the UK, and that waiting for an appointment is frustrating when your doctor has asked you to see a dentist first. Our guide to finding an NHS dentist accepting new patients has practical tips if you are struggling.

When you are ready, search for a dentist near you on Dentists Closeby to compare NHS and private practices in your area. When you book, mention your bone medicine so the practice can plan your care.

Sources

1. Osteoporosis, prevention of fragility fractures: prevalence -- NICE Clinical Knowledge Summaries, last revised April 2025, accessed 2026-10-16
2. Medication-related osteonecrosis of the jaw -- SDCEP, published March 2017, reviewed and extant March 2024, accessed 2026-10-16
3. Oral Health Management of Patients at Risk of Medication-related Osteonecrosis of the Jaw: Guidance in Brief -- SDCEP, published March 2017, reviewed and extant March 2024, accessed 2026-10-16
4. Dental advice for patients prescribed anti-resorptive drugs for the treatment of osteoporosis or other non-malignant diseases of bone -- Scottish Dental Clinical Effectiveness Programme (SDCEP), NHS Education for Scotland, March 2024, accessed 2026-10-16
5. Common questions about alendronic acid -- NHS.uk, last reviewed 7 May 2025, accessed 2026-10-16
6. Drugs with MHRA Safety Update for MRONJ at 21 March 2024 -- SDCEP, 21 March 2024, accessed 2026-10-16
7. How and when to take alendronic acid -- NHS.uk, last reviewed 7 May 2025, accessed 2026-10-16
8. Alendronic acid -- British National Formulary (BNF), NICE, accessed 2026-10-16
9. Risedronate sodium -- BNF, NICE, accessed 2026-10-16
10. Ibandronic acid -- BNF, NICE, accessed 2026-10-16
11. Zoledronic acid -- BNF, NICE, accessed 2026-10-16
12. Denosumab -- BNF, NICE, accessed 2026-10-16
13. Oral Health Management of Patients at Risk of Medication-related Osteonecrosis of the Jaw: Dental Clinical Guidance -- SDCEP, published March 2017, reviewed and extant March 2024, accessed 2026-10-16
14. Osteoporosis: treatment -- NHS.uk, last reviewed 13 October 2022, accessed 2026-10-16
15. Oral Health Management of Patients at Risk of Medication-related Osteonecrosis of the Jaw: Guidance Supplement -- SDCEP, March 2024, accessed 2026-10-16
16. Denosumab (Xgeva, Prolia); intravenous bisphosphonates: osteonecrosis of the jaw, further measures to minimise risk -- MHRA Drug Safety Update, GOV.UK, 20 July 2015, accessed 2026-10-16
17. What happens when you visit the dentist -- NHS.uk, last reviewed 13 March 2025, accessed 2026-10-16
18. Receiving NHS dental treatment in Scotland -- NHS inform, last updated 27 July 2026, accessed 2026-10-16
19. Denosumab 60mg (Prolia): increased risk of multiple vertebral fractures after stopping or delaying ongoing treatment -- Medicines and Healthcare products Regulatory Agency (MHRA) Drug Safety Update, GOV.UK, 26 August 2020, accessed 2026-10-16
20. Drug treatments for osteoporosis: Denosumab -- Royal Berkshire NHS Foundation Trust, reviewed July 2025, accessed 2026-10-16
21. Dental treatments -- NHS.uk, last reviewed 8 July 2026, accessed 2026-10-16
22. Dentures -- NHS.uk, last reviewed 19 March 2025, accessed 2026-10-16
23. How much NHS dental treatment costs -- NHS.uk, last reviewed 13 March 2025, accessed 2026-10-16
24. Side effects of alendronic acid -- NHS.uk, last reviewed 7 May 2025, accessed 2026-10-16
25. Help with NHS dental costs -- NHS Business Services Authority (NHSBSA), accessed 2026-10-16
26. A quick guide to help with health costs (HC12), effective from April 2026 -- NHSBSA, April 2026, accessed 2026-10-16
27. NHS dental charges and exemptions -- Welsh Government (GOV.WALES), last updated 27 July 2026, accessed 2026-10-16
28. Dental Charges and Fees -- HSC Business Services Organisation (Northern Ireland), accessed 2026-10-16
29. Who can get free NHS dental treatment or help with dental costs -- NHS.uk, last reviewed 11 February 2025, accessed 2026-10-16
30. Free NHS dental treatment -- NHSBSA, accessed 2026-10-16
31. Does my medical condition entitle me to help with my NHS health costs? -- NHSBSA, accessed 2026-10-16