Inform Dentist Immunosuppression — SCE Rheumatology MCQ

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EasyRheumatoid ArthritisInform Dentist ImmunosuppressionSCE Rheumatology

A 50-year-old woman with rheumatoid arthritis is receiving adalimumab. She is due to attend her dentist for a routine assessment and asks whether she needs to mention her treatment. What is the most appropriate advice?

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Correct answer: B — Disclose adalimumab and her full medication list before any dental assessment or treatment

Explanation lettering: D = shown as A · E = shown as B · A = shown as C · C = shown as D · B = shown as E

The correct answer is E. A patient receiving adalimumab should tell the dental team about the biologic and provide an up-to-date medication list, including before routine assessment. This permits recognition of treatment-related infection risks and appropriate coordination with rheumatology if an invasive procedure is planned. Disclosure does not mean that adalimumab must automatically be stopped; the patient should not omit doses without specialist advice. Options B and C are too restrictive because medication history is relevant before, not only during, extraction or active infection. Option D confuses biologic safety with medication-related osteonecrosis of the jaw: bisphosphonate use is important but is not a prerequisite for disclosing adalimumab. Controlled rheumatoid arthritis does not remove the need for disclosure, so A is incorrect.

Reference: University Hospitals of Leicester NHS Trust. Adalimumab for eye (ocular) inflammation (uveitis), section 'Is there anything else I should know about Adalimumab?', 2026. https://yourhealth.leicestershospitals.nhs.uk/library/musculoskeletal-specialist-surgery-mss/ophthalmology/4430-adalimumab-for-eye-ocular-inflammation-uveitis/file