Periodontal Status of Patients Taking Biologic Medications

Objectives: Biologic agents are an expanding class of novel therapeutic formulated to directly target disease processes. However, existing investigations in medical and surgical settings have found risks to patients on these agents including increased risk of infection and delayed healing. The impact that these medications have on oral health, specifically periodontal health, is yet to be explored. This study attempted to characterize the periodontal disease experience of patients taking biologic agents in one large academic setting.
Methods: The electronic health records of patients on B and T cell inhibitors, TNF antagonists, and interleukin inhibitors treated at Penn Dental Medicine from July 2017-June 2022 were analyzed. Periodontal data were examined including periodontal diagnoses and treatments including scaling and root planing (SRP) and periodontal surgeries.
Results: The overall cohort was composed of 255 patients born between 1934 and 1998 with 153 females, 97 males, and 1 transgender patient. 180 (70.6%) patients in our cohort received periodontal treatment (107 females, average birth year 1968 (+/-16)). Of those patients, SRP was the most common procedure performed (n=74, 41.1% of periodontal treatments).
Patients taking every biologic agent represented in our institutional cohort except for alemtuzumab and anakinra received periodontal treatment. Periodontal patients were treated most with TNF-alpha inhibitors (60%), followed by interleukin inhibitors (30%), and B/T cell inhibitors (12%) (some patients treated with multiple agents).
Conclusions: When using periodontal treatment to estimate disease, rates were like those reported in literature. 41.1% of our cohort receive this treatment, which is very similar to the national average of adults with periodontal disease (42.2%). However, most patients taking a biologic had some form of periodontal treatment (70%) which may reflect either an increased need for treatment or an increased uptake of services. Further research will provide additional evidence on the impact of biologic medications on periodontal health.