Bisphosphonate dental procedure — GPhC CRA MCQ
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Correct answer: E — Continue current treatment pending coordinated dental and osteoporosis risk review
Continue current treatment pending coordinated dental and osteoporosis risk review: A short self-initiated interruption has unproven benefit because bisphosphonate remains in bone, while dental and fracture risks require coordinated assessment. Stop alendronate for seven days before the planned dental extraction: A one-week pause does not eliminate retained skeletal exposure or all risk. Continue alendronate and tell only the osteoporosis prescriber, not the treating dental practitioner: The dentist needs the medicine history to assess and discuss the small but relevant jaw risk. Take an additional alendronate dose after the dental extraction heals: Dose doubling is unsafe and has no role after a dental procedure. Cancel the extraction and continue long-term antibiotic treatment instead: Necessary dental treatment is not absolutely prohibited and uncontrolled dental infection also causes harm.
Reference: NOGG clinical guideline for osteoporosis: https://www.nogg.org.uk/full-guideline; BNF: alendronic acid: https://bnf.nice.org.uk/drugs/alendronic-acid/