Bisphosphonates are medications used to treat conditions such as osteoporosis, bone metastases, and other issues related to bone loss. They work by inhibiting the activity of osteoclasts, the cells responsible for bone resorption, thus helping to maintain and increase bone density. However, their use has been associated with certain risks, particularly in relation to oral surgery. 

One of the most significant complications that can arise is medication-related osteonecrosis of the jaw (MRONJ). This condition can occur following procedures such as tooth extractions or implant placement, where the bone is exposed or traumatized. Symptoms include pain, swelling, gum inflammation, and exposed bone that fails to heal. 

Patients taking bisphosphonates, especially intravenous forms for treating metastatic cancer, are at higher risk for developing MRONJ. Oral administration for osteoporosis carries a lower, but still present, risk. 

To reduce the risk of these complications, coordination between the dentist and physician is essential. Before any oral surgery, patients should inform their dentist about their bisphosphonate use, and their overall health status should be assessed. In some cases, a temporary discontinuation of the medication may be recommended, always under the guidance of the treating physician. 

Additionally, proper preoperative care and avoiding trauma to the gums and bone during procedures are key. Post-surgical monitoring for signs of infection or complications is crucial for timely intervention. 

In conclusion, understanding the relationship between bisphosphonates and oral surgery is essential for preventing serious complications and ensuring patient safety.