Dental work while on a Biologic for RA

Posted , 4 users are following.

hello, I will be having a crown put on one of my teeth next week. As you know this entails lots of drilling to get the tooth ready for the crown. I am on MTX and Oriencia infusions. When I am scheduled to have this work done I will be 2 weeks from my next infusion. Really right in the middle of my infusion schedule. I am concerned because of all the drilling and gum bleeding that goes with getting a crown. Has anyone had dental work done while on MTX and a Biologic and did you have to go off all the meds, have an antibiotic or etc. I don’t like to go to the dentist anyway but the tooth broke and it’s either pull it or crown it, I don’t have a choice. Thanks Jo


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  • Posted

    I have had a double hip replacement while on MTX, chemists who interviewed me before surgery, said just keep taking as usual, but my timing with hip one was the day after surgery, so refused to have the injection, and hip two was the day after injection, so again, missed that week.

    Surgeon seemed very happy I had missed my injections, from his reaction, don't know if he would have used as excuse to cancel 2nd surgery, but the grilling I got on the operating table gave me that impression.

    ?I always tell any I am on MTX for any medical procedure, they always give you anti-biotics just to make sure, and they also from my understanding treat all your blood and any swabs or towellets they use as a bio hazard, and or cyto-toxic, and not mix them with their regular waste.

    I was in the hospital on purple sheets, purple gowns, purple dressings etc, all by colour a warning to nurses and staff that I was a potential hazard, all my dressing etc were put in purple plastic bags, separate from others in the room, which freaked the other 3 in my room out until it was explained I was not risk to them, they and their natural bacteria were a risk to me because of low immunity.

    ?I was lucky had no issues at all, except a bladder infection that was jumped on from a great height with strong anti-biotics post surgery.

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  • Posted

    Hi Jo, I'm on Benapali / Etanercept (weekly) and prednisolone and had 'Composite' crown treatment a couple of weeks ago to my 2 front teeth, one of which had broken (on holiday!)  I didn't stop anything on this occasion and I haven't had any problems so far. Well none I can put down to this episode anyway. It didn't seem a massive procedure to be honest but may have been nothing like you're having planned. 

    I'm not on Methotrexate any more but I was when I had a knee replacement 3 years ago.  I was told then to only stop my biologic, Humira, 6 weeks before. My surgeon said it would have taken a long time to get the MTX out of my system. I did have my surgery brought forward however, and my surgeon was very particular as to the date I'd stopped my Biologic. He was agreeable  to proceed as it was (just) over the 6 weeks he and my Rheumy had stipulated. I think that was in line with NICE guidelines from what I remember.  I did have infection problems a couple of months down the line. Related? I don't know. 

    Hope you get the information you want and it goes well for you. 

    Carol x

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  • Posted

    I would ask your Dr.  I had to stop both Humira and mtx before and after my shoulder replacement.  A crown is not as invasive so you may be ok to stay on it.  Better to ask to be on the safe side.
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    • Posted

      Thanks to all who have answered my question.  I seem to have problems connecting with my doctor, I am in the states.  Anyway I went to her office today to get an answer about having this procedure.  The answer I got was, it’s ok, just ask the dentist if you should have an antibiotic.  6 weeks ago I had to have a ganglion cyst removed from the back of my hand, so since I was a week away from having my regular dose I just had the surgery and delayed my treatment for a week and a half later, I am fine, although I seem to have a bit of a problem because for some reason there seems to be some fluid left, although it does seem to be going down a little, oh well, I made it through that.  It seems for little things it really doesn’t make a difference but I can see if you are going to have major surgery you should be off the meds.  I hope your shoulder surgery went well and you are not having anymore pain.
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