One in ten thousand develop necrosis on Prolia. These sound like pretty low odds. Glad you are not having problems at this point.

If you do decide to change, make sure you follow Prolia with something else or you might lose all gains and have a higher risk of fracture.

I mentioned the implant issue as it's one that I read about in two studies of anti-resorptive drug-induced osteonecrosis of the jaw and my prosthodontist has seen two cases where osteonecrosis has caused dental implants to fail due to loss of supporting bone. Both patients had taken bisphosphonates for well over a decade. [I have dental implants that are critical to the basic architecture of my bite so it was a big concern I had.] I hasten to add that osteonecrosis is not common, and some people take these drugs for years without developing jaw issues. And science doesn't yet know why some people have a problem and others do not.

The side affects for the bisphosphonates generally include a warning to notify the prescribing physician of any pain or ache or discomfort in the jaw. Maybe one can head off an issue before it develops by changing drugs if experiencing any early side effect like these then. An endocrinologist would likely be able to reassure you about this and/or explore a different drug if appropriate.

UT Southwestern has a website about their BRONJ treatment. What was important to me, in addition to their comprehensive treatment specialty, was that they identify the stages of (rare) osteonecrosis and Stage 1 is where a patient has jaw ache or pain but no other symptoms. The important point is that this can injectable a very early stage and treated. For anyone taking anti-resorptive drugs, then, report any unusual jaw pain or ache or numb feeling to your doctor ASAP just in case. Especially if taking the higher-dose injectables.