Biological agents: what they are, how they affect oral health and how they can modulate oral healthcare

Abstract

Biological agents - biologics, biologicals or biopharmaceuticals - are any medicinal product manufactured in, or extracted from, a biological source. They are often generated by DNA recombinant biotechnology and several dozen therapeutic monoclonal antibodies (mAbs) are now marketed for a variety of indications, increasingly in the management of inflammatory immune-mediated disorders, transplantation rejection and cancer treatments. Immunomodulatory mAbs are expensive, must be given by injection or infusion and can have adverse effects but are increasingly used and can be highly effective agents. This paper reviews these agents and their increasing relevance to oral science and healthcare.

The medically compromised patient: Are dental implants a feasible option?

“…With regard to the use of biologicals, whose use is quite common in immunocompromised patients, it is advisable to discuss with the treating physician whether the administration of the biological has to be modified or specific precautions have to be taken. Biologicals can be accompanied by a variety of oral side effects (Georgakopoulou & Scully, ,b).…”

“…A variety of drugs can have oral manifestations as a side effect or side effects which have to be considered when placing dental implants. Many of these side effects are comprehensively summarized by Scully and co‐authors (Georgakopoulou & Scully, ,b; Scully & Bagan, ). The side effects of chemotherapy, anticoagulants, antiresorptive drugs, and biologics have already addressed.…”

“…Driven by his great interest in and knowledge of diseases with dental and medical involvement, the late Crispian Scully has written numerous papers on phenomena that can be present in medically compromised patients and their treatment (Georgakopoulou & Scully, ,b; Jin et al., ), on the side effects of drugs (Georgakopoulou & Scully, ,b; Scully & Bagan, ) as well as the impact of these phenomena on implant survival and peri‐implant health (Diz, Scully, & Sanz, ). Particularly, the paper of Diz et al.…”

Increasing collaboration between GPs and dental practitioners

“…While GMC guidance states that 'personal information can be disclosed if it is required by law', 4 the benefits of mandatory data submission do not automatically outweigh the potential harm to the patient-doctor relationship and public trust. Our concern is that without assurance of confidentiality, FGM survivors may avoid seeking medical help in general practice, even for non-gynaecological conditions.…”

“…Dentists contact local GP practices for up-to-date lists of medication, and would be more than happy to offer an opinion or advice, so we can continue to provide the highest quality of patient care. With increasingly complex management of patients, 4 dental interception and preventative care are more crucial than ever.…”