Thanks for your question! There are different schools of thought on this according to different experts. Some say you should stop Fosamax for three months before oral surgery, others say don't bother because the Fosamax will still be in your system and the chance of osteonecrosis of the jaw is remote anyhow. My advice is to consider, in consultation with both your physician and your dentist, the severity of the tooth situation and that of the osteoporosis. If your tooth is severely infected or you are in a lot of pain, you might proceed differently than if your dentist believes the procedure is one to be done "eventually" and that you could safely wait a few months. Also, your doctor who prescribes Fosamax may have some insight on your bone denisty and how serious your risk of fracture might be after a few months off the medication. Good luck with this.