Our Summary

This research paper discusses the use of biological therapies, which are medicines made from living organisms, in treating chronic inflammatory, autoimmune, and cancer conditions. However, these treatments can present challenges when it comes to oral and facial surgery. This is because they can affect how wounds heal, the risk of infection, and the body’s immune responses.

The paper reviews common biological agents used in treatments and provides safety guidelines for managing patients on these therapies who need oral surgeries. These surgeries could include tooth extractions, implant placements, gum and soft tissue surgeries, and removal of non-cancerous or cancerous growths in the mouth.

Some things to consider include potential complications in the mouth caused by these treatments, assessing risk before surgery, timing of administering the biologics during surgery, and monitoring after surgery to prevent complications.

Currently, there are no specific guidelines for managing these biological agents in relation to dental or oral surgeries. This paper aims to look at existing research and recommendations on the use of these agents during the time around surgery.

FAQs

  1. How can biological therapies affect oral and facial surgery procedures?
  2. What are the common biological agents used in treatments that can potentially complicate oral surgeries?
  3. What are some considerations to make when a patient on biological therapies needs oral surgery?

Doctor’s Tip

A doctor may advise a patient undergoing oral surgery while on biological therapies to inform their oral surgeon about their medication and work closely with both their medical and dental providers to ensure a safe and successful outcome. It is important to follow all pre and post-operative instructions carefully to minimize any potential risks or complications. Additionally, the patient should be aware of any signs of infection or delayed healing and contact their healthcare provider immediately if any concerns arise.

Suitable For

Patients who are typically recommended for oral surgery include those with:

  1. Impacted wisdom teeth: Wisdom teeth that are impacted or causing pain may need to be extracted through oral surgery.

  2. Dental implants: Patients who are missing teeth may require dental implants to restore their smile and chewing ability.

  3. Jaw misalignment: Oral surgery may be recommended to correct issues with the alignment of the jaw, such as TMJ disorders.

  4. Facial trauma: Patients who have experienced facial trauma, such as fractures or injuries, may require oral surgery to repair and reconstruct the affected area.

  5. Oral pathology: Patients with oral lesions, cysts, or tumors may need oral surgery to remove the abnormal tissue and prevent further complications.

  6. Obstructive sleep apnea: Oral surgery may be recommended to treat obstructive sleep apnea by removing excess tissue in the throat that obstructs the airway during sleep.

  7. Temporomandibular joint (TMJ) disorders: Patients with TMJ disorders that cause pain, clicking, or limited jaw movement may benefit from oral surgery to correct the issue.

It is important for patients to consult with their healthcare provider to determine if oral surgery is the best course of treatment for their specific condition. Additionally, patients with certain medical conditions or taking specific medications may need to be evaluated for any potential risks or complications before undergoing oral surgery.

Timeline

Before oral surgery:

  • Patient is assessed for their overall health and any medical conditions they may have
  • Patient’s medications, including biological agents, are reviewed to determine if any adjustments need to be made
  • Patient may undergo pre-operative testing to ensure they are healthy enough for surgery
  • Patient is given instructions on how to prepare for surgery, including fasting before the procedure
  • Patient may be prescribed antibiotics or other medications to prevent infection

During oral surgery:

  • Patient receives anesthesia to numb the area or put them to sleep, depending on the procedure
  • Surgeon performs the necessary procedure, such as tooth extraction or implant placement
  • Surgeon may need to take extra precautions due to the patient being on biological agents, such as using special techniques to minimize bleeding or infection risk

After oral surgery:

  • Patient is monitored closely for any complications, such as bleeding, infection, or delayed healing
  • Patient may be prescribed pain medication and antibiotics to manage pain and prevent infection
  • Patient is given instructions on how to care for the surgical site, such as avoiding certain foods and activities
  • Patient may need to follow up with the surgeon for additional care or monitoring, depending on the complexity of the surgery and their health status.

What to Ask Your Doctor

Some questions a patient should ask their doctor about oral surgery when on biological therapies include:

  1. How will my current biological therapy medication affect the healing process after oral surgery?
  2. Are there any specific precautions or adjustments that need to be made to my medication regimen before and after surgery?
  3. What are the potential risks or complications associated with undergoing oral surgery while on biological therapies?
  4. Will I need any additional monitoring or follow-up care after the surgery due to my medication?
  5. How will the timing of my medication doses impact the surgery and recovery process?
  6. Are there any alternative treatment options or adjustments to my medication that could minimize risks during oral surgery?
  7. What steps will be taken to reduce the risk of infection or other complications during and after the surgery?
  8. How will my immune response be affected by the surgery and my medication, and what implications does this have for my overall health?
  9. Are there any specific guidelines or recommendations for managing biological therapies in relation to oral surgeries that I should be aware of?
  10. What is the expected recovery process like for someone on biological therapies undergoing oral surgery, and what signs should I watch for that may indicate a problem?

Reference

Authors: Dinkova AS, Petrov PG. Journal: Discov Med. 2025 Mar;37(194):442-457. doi: 10.24976/Discov.Med.202537194.37. PMID: 40116093