Can Biologics and Dental Work Go Hand in Hand? Here’s the Answer!

It turns out that oral health plays a pivotal role in physical well-being. The Biologics sector is compelling and emerging, with many potential applications and caution notes pertaining to dentistry. The use of biologics in dentistry is an invigorating development that has generated significant debate.

The rousing inference between biologics and dental work is indubitable.

The tie-up between the mouth and body has been interpreted more in recent years, with startling results. It has been scientifically proven that the mouth is intricately connected with our health. It is a raveled interdependence between the two. For instance, gum disease is an unpleasant and severe health issue that can lead to life-threatening conditions such as heart risk disorders or diabetes.

Let’s dive into the debate!

Having dental extractions or implants while on Stelara can lead to dental abscess and gums discomfort. For this reason, it is preferred to consult your dentist before having any dental work done if you’re on Stelara drugs.

Biologics and Dental Work: Role of Biologics In Dentistry

Biologics are the biological counterpart to traditional manufactured chemicals and supplements.

The field of implant dentistry has set its foot in an advanced provocative era of biologics. This new challenge will be substantially more consequential and contended than the bisphosphonates in the past few decades.

biologics-and-dental-work

Introducing a more contemporary class of disease-fighting sanative medicament, i.e., biologics, has revolutionized our thinking about treatment in modern medicine. Biologics can treat various diseases, including autoimmune disorders, neoplasms, and other infectious diseases. 

Biologic Medications

The pharmaceutical industry is booming with growth anticipating from a contemporary and riveting sector – biological therapeutics, unlike the conventional curatives.

Biologics are a class of immunosuppressants that target the body’s immune system to combat diseases and can be safe and effective for treating many conditions, from rheumatoid arthritis to numerous cancers.

Brand NameGeneric NameDiseases To Be Treated
HumiraAdalimumabRheumatoid arthritis, psoriatic, JIA, ankylosing spondylitis
RemicadeInfliximabCrohn’s disease, rheumatoid arthritis, sarcoidosis, ankylosing spondylitis
HerceptinTrastuzumabBreast cancer, esophageal cancer, metastatic gastric adenocarcinoma
EnbrelEtanerceptRheumatoid arthritis, plaque psoriasis, psoriatic arthritis, active ankylosing spondylitis, JIA, axial spondyloarthritis
ProliaDenosumabOsteoporosis
StelaraUstekinumabCrohn’s disease, ulcerative colitis, plaque psoriasis
CosentyxSecukinumabPsoriasis, ankylosing spondylitis, psoriatic arthritis

Some Complications of Biologics In Implant Dentistry

Biologics have fewer side effects than traditional counterparts. Still, they also may carry potential risks to your health and trigger allergic reactions in some people.

implant-dentistry

Although research on biological drugs is limited, many cases reported in dental literature document the effects of these treatments in invasive dental procedures such as extractions, bone grafts, and dental implants.

Immunosuppressants and Dental Extractions:

The altercation of dental work while on immunotherapy has gained notable gravity. Let’s see how different biologics can be implicated in dentistry and the correspondence between biologics and dental work.

Can You Have Dental Work While On Humira?

Many people ask questions like, is it imperative to go off Humira before dental extractions, or can you have dental work while on Humira?

Humira or Adalimumab (generic name) is an immunosuppressant drug used to treat different types of arthritis and Crohn’s disease. Many case studies have revealed that patients with Crohn’s disease or rheumatoid arthritis who are on Humira rarely tend to develop osteonecrosis of the jaws as an adverse effect of the drug

humira

Hence, Adalimumab and dental extractions are negatively associated, as implant loss and bone infection may develop in individuals taking Adalimumab. On that account, it is better not to have dental work while on Humira.

Stelara and Dental Work:

Ustekinumab, an active ingredient of Stelara, is a human monoclonal antibody that works by suppressing the immune system to fight conditions like psoriasis, and eczema, etc. In dental literature, many queries come into the discussion, like do patients on Stelara treatment experience any dental infections? The answer to this question is intricate and squabble.

Some reports and case studies suggest that it doesn’t have any unpropitious outcomes over oral health.

In contrast, others advocate that having dental extractions or implants while on Stelara can lead to dental abscess and gums discomfort. For this reason, it is preferred to consult your dentist before having any dental work done if you’re on Stelara drugs.

Enbrel Dental Considerations:

Enbrel is an immunosuppressant drug used to treat arthritis, spondylitis, psoriasis, and JIA. If we talk about Enbrel dental considerations, then it is considered entirely safe to have dental extractions during its course. However, some reports reveal that it could occasionally cause severe afflictions in oral health, leading to root abscesses or gums bleeding.

enbrel

Secukinumab and Dental Extractions:

For those who have tried everything and are still struggling with psoriasis, a Secukinumab (Cosentyx) injection may be an option.

Secukinumab is a drug with higher potential risks for dental extractions. It might increase your risk of getting an infection after surgical procedures. For that reason, it is requisite to tell your doctor before any dental work that you are taking Secukinumab or whether you should continue it or not.

Prolia and Its Relevance With Dental Work:

The Denosumab injection (Prolia) is a drug used to treat osteoporosis caused by the effects of corticosteroids on your body. In its correspondence with dentistry, it is a common question: Does Prolia interfere with dental work? Or can I have dental work while on Prolia?

Patients, particularly women, who have to get their teeth extracted are at a high risk of developing jaw-related problems with Prolia.  Studies quantify that Prolia benefits menopausal women in aiding their osteoporosis; meanwhile, it may increase the risk of dental issues. Therefore, getting off the medication before dental extraction is essential.

Remicade and Dental Work:

Being a biological drug and an immunosuppressant, there are mixed reports about whether or not Remicade affects your dental procedures. While the drug can increase the risk for oral infections, some cases reveal that dental procedures following Remicade do not lead to complications.

Therefore, somehow immunotherapy can lead to oral health changes from mouth sores to salivary gland dysfunctions. Consequently, having dental work while on immunotherapy can be perilous and precarious often.

Biologics, Biopharmaceuticals and Biotech:

You must be wondering about the difference between biologics and biopharmaceuticals. It’s just a matter of terms, but both correspond to the same methodology of curing different ailments. A biopharmaceutical product is a medical product, also known as a biologic, derived from living sources.

Considering the difference between biologics and biotech, biotech is the technique by which biologics are being made. It is a DNA recombinant technology that uses living sources for the benefit of humankind.

How Long Does it Take Biologics to Work?

Since every medicine or therapeutic drug takes time, how long do biologics take to work? Or how quickly do they work?

The patient should not expect to notice an improvement in symptoms immediately as biologics take time to work. The signs and the severity might start decreasing from the first week till the twelfth week, but it could also take as long as six months or even more to witness significant improvements.

Does Aetna Cover Biologics?

Aetna is a medical health insurance Medicaid company that offers health insurance, dental, vision, and several other plans.

Aetna covers biologic drugs like Humira, Enbrel, Remicade, Stelara, etc., under precertification criteria, and these drugs can only be given to those patients who meet their standards.

FAQs:

1.Does immunotherapy affect your teeth?

Immunotherapy can be a less toxic alternative to chemotherapy, but it’s associated with its side effects, which can be diverse and sometimes challenging to manage. The side effects of immunotherapy can be mouth sores, damage to tooth enamel, and other gum-related disorders.

2.How long does it take for biologics to get out of your system?

Depending upon the nature and half-life of the drug, different biologics vary with their stay in your system. For instance, Cosentyx may take up to 110 to 155 days to be eliminated from your system, whereas Humira may take as long as six months to leave the body after its administration has been stopped completely.

3.Can you have dental work while on methotrexate?

Methotrexate is an immunosuppressant to treat conditions like rheumatoid arthritis. Before having any dental implants, your oral surgeon will consult your doctor if you are on methotrexate. Accordingly, if taken with precautions, there is no harm in having dental work while on methotrexate.

4.How long can you stay on a biologic?

There is no exact answer to this query. However, it has been reported that some drugs can improve the symptoms within 3-4 months, whereas others might have some adverse effects too. No matter how the life expectancy of patients with autoimmune disorders has markedly increased in recent decades with these prodigious biologics.

Crux of the Matter

Although biologics are the most advanced therapies available and can treat various diseases with greater precision than traditional medicines, the connection between biologics and dental work is still perplexing and tortuous.

Targeted therapies and biologics are promising approaches for treating various cancers and autoimmune diseases and require healthy awareness of immune-related adversities to reduce morbidity in dentistry. 

To help reduce the risk of interruptions in immunotherapy, oral health professionals must be erudite in immune responses induced by different biologics in contrast to implant dentistry.

Minahil Laraib Asif

Minahil Laraib Asif

Hi, This is Minahil Laraib Asif, an MBBS student from Karachi Medical and Dental College (KMDC) in Pakistan. Studying medicine is my passion, and the desire to live my life in service to humanity has led me to pursue my career in medicine. As a medical student, it's essential to know how to balance projects and work while maintaining a healthy social life. Investigating and exploring newer disclosures has always been a source of gratification for me. For this reason, I have developed my career in writing articles as well, since it brings me great delight while researching various projects, and presenting such information to people, that they may otherwise never come across.

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