Dental work and Biologics (Tocilizumab).

Becky88

Good Afternoon,
I was just wondering if anyone out there could give me some advice about having dental work done whilst being on biological therapy infusions. I have read/been told to be careful of any invasive dental work...but what do you think counts as invasive? Would it even include an injection, scrap and polish, crown, filling, etc. Any help would be gratefully received... Many thanks.

stickywicket

This question has come up before a few times but, unfortunately, there doesn't seem to be any one answer. It's not just biologics. Even ordinary DMARDS come under the same brolly.

I take methotrexate and hydroxychloroquine and no-one ever told me to beware dentistry When I read about such matters on here I asked my dentist who said she'd not heard of it though her predecessor did once put me on 3 days worth of precautionary antibiotics after an extraction. Then we moved and my current dentist doesn't bother either. But I recall one lady on methotrexate who was given antibios after every scrape and polish.

The fear is obviously that of introducing infection but I've had major operations where antibios were not administered afterwards so what does one conclude? I think you can only check with your rheumatologist and dentist.

Becky88

Thank you very much stickywicket. I appreciate you answering me. It is nice to know there are people out there who understand.

BettyMac

I would count root canal treatment and extraction as invasive types of treatment.
For most people, a routine scale and polish wouldn’t be invasive but if you have active periodontal disease and need deep cleaning, that’s probably a higher risk
Definitely take advice from your dentist and hygienist.
It might also be worth a chat with your rheumatology nurse.

Jackie47

My dentist was aware of the connection. As there was a possibility of an extraction she spoke with the specialist nurses at the hospital . All dentists should be up to speed and if not why not?

trepolpen

if you are worried talk to your rheumy nurse , filling should be fine but I take daily tablets & told to stop if having a extraction , monthly infusion is a bit different , so get advice for your hospital