Methotrexate and Gum Disease


I have a patient, in her late 50’s, of long duration who had a deep cleaning for significant periodontal disease, not bad enough to require periodontal surgery. She returned for her 3 month periodontal maintenance having looked awesome for her last 4-5 visits, and suddenly she had bleeding 5-7 mm. pockets in all of her molar areas. This did not make sense as she reported that she has maintained her high quality home care.


Being a nurse she continued to wonder what changed. She recalled that she was recently having some difficulty with psoriasis and her physician placed her on methotrexate. She then looked on the internet and found that methotrexate can play a significant role in triggering periodontal disease.

According to WEB MD, this is just one of the significant side effects seen with this particular drug.

For this patient she required another round of deep scaling and root planing, the non-surgical treatment as part of a periodontal treatment regimen. She spoke with her doctor about this development and the methotrexate treatments were discontinued.  She was seen again this week and looked perfect.

This case is just another reminder that drugs taken for one part of the body can have significant side effects in other parts of the body. Fortunately the side condition has been turned around to a great result.