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Biologics and Dental Procedures — SCE Rheumatology MCQ

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EasyRheumatology PharmacologyBiologics and Dental ProceduresSCE Rheumatology

A 42-year-old woman with RA has disease that is well controlled on Methotrexate and Adalimumab. She requires a dental extraction. What advice should she receive regarding her biologic therapy perioperatively?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — For minor dental procedures Adalimumab can generally be continued; ensure good antibiotic prophylaxis if indicated and inform the dentist about immunosuppression

For minor dental procedures (extractions fillings) biologic therapy can generally be continued. BSR biologic safety guidelines reserve the recommendation to withhold biologics for one dosing cycle for major surgery with significant infection risk. Good dental hygiene prophylactic antibiotics if indicated (e.g. for patients at high infective endocarditis risk) and informing the dental team about immunosuppressive therapy are important. The key distinction is between minor dental procedures (continue biologic) and major surgical procedures (omit one dose cycle before surgery). Methotrexate can be continued for dental procedures.

Reference: BSR 2019 biologic safety guidelines