A patient on oral bisphosphonate therapy (alendronate) for 2 years requests full-mouth extractions to be fitted for complete dentures. What is the most appropriate first action?

Oral bisphosphonates (e.g., alendronate, risedronate) are associated with medication-related osteonecrosis of the jaw (MRONJ), a potentially serious complication following invasive dental procedures such as extractions. The risk increases with duration of use (>3 years), concurrent corticosteroid use, and patient systemic factors. Before proceeding with full-mouth extractions, the dentist must consult with the prescribing physician to assess the risk-benefit ratio, discuss the possibility of a 'drug holiday' (temporary discontinuation), and evaluate whether the bisphosphonate is essential for osteoporosis management. Simply extracting all teeth without consultation is inappropriate. Unilaterally stopping the medication for 2 months without physician guidance is also inappropriate, as the drug has a long half-life in bone (years).