Methotrexate

Oral health effects

• Oral mucositis / ulceration

  Painful mucosal ulceration is a dose-related toxicity, more common at higher (oncologic) doses but possible with weekly low-dose therapy.

  Mechanism: Inhibition of rapidly dividing mucosal epithelial cells (folate antagonism).

  Clinical management: Bland diet, atraumatic hygiene, topical analgesia; folate per physician; report severe mucositis to the prescriber.

• Increased infection / candidiasis risk & delayed healing

  Systemic immunosuppression raises the risk of oral candidiasis, viral reactivation (HSV), and delayed wound healing.

  Clinical management: Monitor for fungal/viral infection; emphasize hygiene; consider antimicrobial prophylaxis per medical advice; plan atraumatic care and coordinate timing of invasive procedures.