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necessary remedial work should be performed) before bisphosphonate treatment, or as soon as possible after starting treatment. During bisphosphonate treatment patients should maintain good oral hygiene, receive routine dental check-ups, and report any oral symptoms.
B: Bisphosphonates: atypical femoral fractures
Atypical femoral fractures have been reported rarely with bisphosphonate treatment, mainly in patients receiving long- term treatment for osteoporosis. The need to continue bisphosphonate treatment for
osteoporosis should be re-evaluated periodically based on an assessment of the benefits and risks of treatment for individual patients, particularly after five or more years of use. Patients should be advised to report any thigh, hip, or groin pain during treatment with a bisphosphonate. Discontinuation of bisphosphonate treatment in patients suspected to have an atypical femoral fracture should be considered after an assessment of the benefits and risks of continued treatment.