Can taking Plaquenil (hydroxychloroquine) cause issues with getting a dental implant?

Hydroxychloroquine (Plaquenil) and Dental Implant Safety

Taking Plaquenil (hydroxychloroquine) does not pose a significant risk for dental implant procedures, and there is no need to discontinue the medication before implant surgery.

Medication Profile and Considerations

Hydroxychloroquine (Plaquenil) is an antimalarial medication commonly used for autoimmune conditions. When considering its impact on dental implant procedures:

• Hydroxychloroquine is partially metabolized by the liver and primarily excreted through the kidneys (95% in urine) 1
• Unlike other medications that directly impact bone healing or increase bleeding risk, hydroxychloroquine has not been identified as a contraindication for dental implant surgery
• The medication does not appear on lists of absolute contraindications for dental implant therapy 2

Potential Concerns and Management

While hydroxychloroquine itself doesn't directly interfere with implant osseointegration, there are some considerations to be aware of:

Bleeding Risk

• Unlike antiplatelet medications (which have been studied and shown not to increase bleeding risk during implant surgery) 3, hydroxychloroquine does not have anticoagulant properties that would increase bleeding risk

Infection Risk

• Hydroxychloroquine is not associated with increased infection risk that would necessitate special antibiotic prophylaxis beyond standard protocols 4, 5
• If antibiotic prophylaxis is needed, clindamycin (600mg orally 1 hour before procedure) is recommended for patients with medication allergies 6

Long-term Medication Effects

• Long-term hydroxychloroquine use can cause side effects including:
  • Retinopathy (requires regular ophthalmologic monitoring every 6-12 months) 1
  • Potential cardiac effects (ECG abnormalities such as QRS widening and T-wave changes) 1
  • Rarely, myopathy or peripheral neuropathy 1
• None of these side effects directly impact dental implant success or osseointegration

Special Considerations for Implant Surgery

If you're taking hydroxychloroquine and planning dental implant surgery:

1. Inform your dental provider about all medications you're taking, including hydroxychloroquine
2. No need to discontinue hydroxychloroquine before or after implant surgery
3. Follow standard post-operative care recommendations
4. Monitor for healing as you would with any dental implant procedure

Conclusion for Clinical Practice

A comprehensive review of medication effects on dental implant outcomes found no evidence that hydroxychloroquine increases implant failure risk 7. The dental provider should be aware of your medication regimen but does not need to modify the standard implant protocol based solely on hydroxychloroquine use.