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Home / Ask the Expert / Dental work and remicade

Dental work and remicade

October 22, 2009 By Arthritis Center

Question

In order to replace an abscessed mandibular anterior tooth, I will need either a block graft and two dental implants or simply two dental implants. I have Remicade infusions every eight weeks and my doctors are worried about failure of their work cause by an infection or increased risk of infection for me. Ultimately the choice will be mine and I need some advice. I take two 200mg tabs of Plaquenil each day along with Remicade. Any advise will be deeply appreciated.

Answer

HI Helen,

The TNF inhibitor class of drugs which includes Humira has been associated with an increased risk of some infections.  They may predispose to infections in bone around the time of surgery (like in joint replacements), although this is somewhat controversial in the medical literature.  We usually err on the side of safety, and stop Humira for one month prior to any bone surgery (which includes tooth surgery).  That means the last dose of Humira should be one month before the date of the surgery.  Others only stop it for two weeks.  There is no right answer except that it would not be wise to take Humira right before the surgery.  Good luck !!

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