{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T05:32:47Z","timestamp":1791955967671,"version":"4.3.4"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008331","name":"Universidade Federal Do Rio De Janeiro","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008331","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Odontology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to describe and evaluate the available evidence on oral soft tissue manifestations in individuals with RA receiving antirheumatic therapy, highlighting clinical patterns, implicated drugs, and existing knowledge gaps. A scoping review was conducted through comprehensive searches in PubMed, Scopus, Web of Science, Embase, and LILACS, complemented by gray literature. Eligible studies included observational and interventional designs that assessed oral soft tissue manifestations related to the use of antirheumatic agents in RA. Data were extracted and summarized descriptively according to study design and clinical outcomes. Fourteen studies comprising 4446 RA patients were included, of whom 3452 were females (77.6%), predominantly aged 40\u201360\u00a0years. Methotrexate was the most frequently used agent, followed by leflunomide, sulfasalazine, hydroxychloroquine, and corticosteroids. Oral ulcers were the most prevalent oral soft tissue manifestation, reported in 406 instances (9.13%), typically occurring during methotrexate therapy, with variable duration and distribution. Xerostomia was reported in 87 patients (1.95%), and 28 (0.6%) episodes of stomatitis were identified particularly among patients using multiple disease-modifying antirheumatic drugs. In most studies, lesions were mild and managed symptomatically, without discontinuation of therapy. In summary, oral manifestations represent clinically relevant yet underrecognized adverse effects of antirheumatic therapy in RA. Strengthening collaboration between rheumatologists and oral medicine specialists is crucial for early recognition, accurate differential diagnosis, and prevention of severe outcomes.<\/jats:p>","DOI":"10.1007\/s10266-026-01358-8","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T18:14:41Z","timestamp":1773166481000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Oral soft tissue manifestations in patients with rheumatoid arthritis undergoing antirheumatic therapy: a scoping review"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9769-5159","authenticated-orcid":false,"given":"Beatriz Braga","family":"Ten\u00f3rio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8121-4969","authenticated-orcid":false,"given":"Laura Lemos da Silva","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1949-4087","authenticated-orcid":false,"given":"Pedro Albuquerque Counago","family":"Marques","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6677-1644","authenticated-orcid":false,"given":"Bruna Cristina Oliveira","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6599-3950","authenticated-orcid":false,"given":"Jos\u00e9 Alcides Almeida","family":"de Arruda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3259-606X","authenticated-orcid":false,"given":"Bruno Augusto Benevenuto","family":"de Andrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6986-9148","authenticated-orcid":false,"given":"Jefferson R.","family":"Ten\u00f3rio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"issue":"4","key":"1358_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/cells9040880","volume":"9","author":"YJ Lin","year":"2020","unstructured":"Lin YJ, Anzaghe M, Sch\u00fclke S. Update on the pathomechanism, diagnosis, and treatment options for rheumatoid arthritis. Cells. 2020;9(4):880. https:\/\/doi.org\/10.3390\/cells9040880.","journal-title":"Cells"},{"issue":"2","key":"1358_CR2","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1002\/art.41417","volume":"73","author":"KD Deane","year":"2021","unstructured":"Deane KD, Holers VM. Rheumatoid arthritis pathogenesis, prediction, and prevention: an emerging paradigm shift. Arthritis Rheumatol. 2021;73(2):181\u201393. https:\/\/doi.org\/10.1002\/art.41417.","journal-title":"Arthritis Rheumatol"},{"issue":"4","key":"1358_CR3","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2024.101968","volume":"38","author":"SD Sharma","year":"2024","unstructured":"Sharma SD, Leung SH, Viatte S. Genetics of rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2024;38(4):101968. https:\/\/doi.org\/10.1016\/j.berh.2024.101968.","journal-title":"Best Pract Res Clin Rheumatol"},{"issue":"5","key":"1358_CR4","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1007\/s00296-020-04731-0","volume":"41","author":"K Almutairi","year":"2021","unstructured":"Almutairi K, Nossent J, Preen D, Keen H, Inderjeeth C. The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review. Rheumatol Int. 2021;41(5):863\u201377. https:\/\/doi.org\/10.1007\/s00296-020-04731-0.","journal-title":"Rheumatol Int"},{"issue":"10","key":"1358_CR5","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1038\/s41584-022-00827-y","volume":"18","author":"A Finckh","year":"2022","unstructured":"Finckh A, Gilbert B, Hodkinson B, Bae SC, Thomas R, Deane KD, et al. Global epidemiology of rheumatoid arthritis. Nat Rev Rheumatol. 2022;18(10):591\u2013602. https:\/\/doi.org\/10.1038\/s41584-022-00827-y.","journal-title":"Nat Rev Rheumatol"},{"issue":"1","key":"1358_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/s40364-025-00760-8","volume":"13","author":"Y Ma","year":"2025","unstructured":"Ma Y, Chen H, Lv W, Wei S, Zou Y, Li R, et al. Global, regional and national burden of rheumatoid arthritis from 1990 to 2021, with projections of incidence to 2050: a systematic and comprehensive analysis of the Global Burden of Disease study 2021. Biomark Res. 2025;13(1):47. https:\/\/doi.org\/10.1186\/s40364-025-00760-8.","journal-title":"Biomark Res"},{"issue":"2","key":"1358_CR7","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/j.rdc.2022.02.010","volume":"48","author":"JJ Cush","year":"2022","unstructured":"Cush JJ. Rheumatoid arthritis: early diagnosis and treatment. Rheum Dis Clin North Am. 2022;48(2):537\u201347. https:\/\/doi.org\/10.1016\/j.rdc.2022.02.010.","journal-title":"Rheum Dis Clin North Am"},{"issue":"10416","key":"1358_CR8","doi-asserted-by":"publisher","first-page":"2019","DOI":"10.1016\/S0140-6736(23)01525-8","volume":"402","author":"A Di Matteo","year":"2023","unstructured":"Di Matteo A, Bathon JM, Emery P. Rheumatoid arthritis. Lancet. 2023;402(10416):2019\u201333. https:\/\/doi.org\/10.1016\/S0140-6736(23)01525-8.","journal-title":"Lancet"},{"issue":"6","key":"1358_CR9","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1136\/annrheumdis-2019-216243","volume":"79","author":"PH Hsieh","year":"2020","unstructured":"Hsieh PH, Wu O, Geue C, McIntosh E, McInnes IB, Siebert S. Economic burden of rheumatoid arthritis: a systematic review of literature in biologic era. Ann Rheum Dis. 2020;79(6):771\u20137. https:\/\/doi.org\/10.1136\/annrheumdis-2019-216243.","journal-title":"Ann Rheum Dis"},{"issue":"3","key":"1358_CR10","doi-asserted-by":"publisher","first-page":"284","DOI":"10.31138\/mjr.20230801.oo","volume":"34","author":"M Jahid","year":"2023","unstructured":"Jahid M, Khan KU, Rehan-Ul-Haq, Ahmed RS. Overview of rheumatoid arthritis and scientific understanding of the disease. Mediterr J Rheumatol. 2023;34(3):284\u201391. https:\/\/doi.org\/10.31138\/mjr.20230801.oo.","journal-title":"Mediterr J Rheumatol"},{"issue":"1","key":"1358_CR11","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1136\/ard-2022-223413","volume":"82","author":"P Studenic","year":"2023","unstructured":"Studenic P, Aletaha D, de Wit M, Stamm TA, Alasti F, Lacaille D, et al. American College of Rheumatology\/EULAR remission criteria for rheumatoid arthritis: 2022 revision. Ann Rheum Dis. 2023;82(1):74\u201380. https:\/\/doi.org\/10.1136\/ard-2022-223413.","journal-title":"Ann Rheum Dis"},{"issue":"13","key":"1358_CR12","doi-asserted-by":"publisher","first-page":"1051082","DOI":"10.3389\/fimmu.2022.1051082","volume":"22","author":"D Wu","year":"2022","unstructured":"Wu D, Luo Y, Li T, Zhao X, Lv T, Fang G, et al. Systemic complications of rheumatoid arthritis: focus on pathogenesis and treatment. Front Immunol. 2022;22(13):1051082. https:\/\/doi.org\/10.3389\/fimmu.2022.1051082.","journal-title":"Front Immunol"},{"issue":"2","key":"1358_CR13","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1097\/CRD.0000000000000486","volume":"32","author":"N Sanghavi","year":"2024","unstructured":"Sanghavi N, Ingrassia JP, Korem S, Ash J, Pan S, Wasserman A. Cardiovascular manifestations in rheumatoid arthritis. Cardiol Rev. 2024;32(2):146\u201352. https:\/\/doi.org\/10.1097\/CRD.0000000000000486.","journal-title":"Cardiol Rev"},{"issue":"160","key":"1358_CR14","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0011-2021","volume":"30","author":"S Kadura","year":"2021","unstructured":"Kadura S, Raghu G. Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management. Eur Respir Rev. 2021;30(160):210011. https:\/\/doi.org\/10.1183\/16000617.0011-2021.","journal-title":"Eur Respir Rev"},{"issue":"10","key":"1358_CR15","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1016\/j.autrev.2011.04.018","volume":"10","author":"E Gremese","year":"2011","unstructured":"Gremese E, Ferraccioli G. The metabolic syndrome: the crossroads between rheumatoid arthritis and cardiovascular risk. Autoimmun Rev. 2011;10(10):582\u20139. https:\/\/doi.org\/10.1016\/j.autrev.2011.04.018.","journal-title":"Autoimmun Rev"},{"issue":"4","key":"1358_CR16","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1016\/j.rdc.2017.06.005","volume":"43","author":"K DeQuattro","year":"2017","unstructured":"DeQuattro K, Imboden JB. Neurologic Manifestations of Rheumatoid Arthritis. Rheum Dis Clin North Am. 2017;43(4):561\u201371. https:\/\/doi.org\/10.1016\/j.rdc.2017.06.005. (Epub 2017 Aug 31 PMID: 29061242).","journal-title":"Rheum Dis Clin North Am"},{"issue":"3","key":"1358_CR17","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2022.101757","volume":"36","author":"KD Wysham","year":"2022","unstructured":"Wysham KD, Baker JF, Narla R. Osteoporosis and fractures in rheumatoid arthritis - risk factors. Best Pract Res Clin Rheumatol. 2022;36(3):101757. https:\/\/doi.org\/10.1016\/j.berh.2022.101757.","journal-title":"Best Pract Res Clin Rheumatol"},{"issue":"4","key":"1358_CR18","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3899\/jrheum.2023-0334","volume":"51","author":"LJ O\u2019Neil","year":"2024","unstructured":"O\u2019Neil LJ, Alp\u00edzar-Rodr\u00edguez D, Deane KD. Rheumatoid arthritis: the continuum of disease and strategies for prediction, early intervention, and prevention. J Rheumatol. 2024;51(4):337\u201349. https:\/\/doi.org\/10.3899\/jrheum.2023-0334.","journal-title":"J Rheumatol"},{"key":"1358_CR19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2019.102400","volume":"110","author":"HU Scherer","year":"2020","unstructured":"Scherer HU, H\u00e4upl T, Burmester GR. The etiology of rheumatoid arthritis. J Autoimmun. 2020;110:102400. https:\/\/doi.org\/10.1016\/j.jaut.2019.102400.","journal-title":"J Autoimmun"},{"issue":"2","key":"1358_CR20","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1136\/ard-2023-224742","volume":"83","author":"V Konzett","year":"2024","unstructured":"Konzett V, Kerschbaumer A, Smolen JS, Kristianslund EK, Provan SA, Kvien TK, et al. Definition of rheumatoid arthritis flare based on SDAI and CDAI. Ann Rheum Dis. 2024;83(2):169\u201376. https:\/\/doi.org\/10.1136\/ard-2023-224742.","journal-title":"Ann Rheum Dis"},{"issue":"6","key":"1358_CR21","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1136\/annrheumdis-2016-210715","volume":"76","author":"JS Smolen","year":"2017","unstructured":"Smolen JS, Landew\u00e9 R, Bijlsma J, Burmester G, Chatzidionysiou K, Dougados M, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update. Ann Rheum Dis. 2017;76(6):960\u201377. https:\/\/doi.org\/10.1136\/annrheumdis-2016-210715.","journal-title":"Ann Rheum Dis"},{"issue":"1","key":"1358_CR22","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s11010-022-04492-3","volume":"478","author":"P Prasad","year":"2023","unstructured":"Prasad P, Verma S, Surbhi, Ganguly NK, Chaturvedi V, Mittal SA. Rheumatoid arthritis: advances in treatment strategies. Mol Cell Biochem. 2023;478(1):69\u201388. https:\/\/doi.org\/10.1007\/s11010-022-04492-3.","journal-title":"Mol Cell Biochem"},{"issue":"4","key":"1358_CR23","doi-asserted-by":"publisher","first-page":"47","DOI":"10.3238\/arztebl.m2021.0388","volume":"119","author":"C Schmidt","year":"2022","unstructured":"Schmidt C, Ertel T, Arbogast M, H\u00fcgle B, Kalle TV, Neff A. The diagnosis and treatment of rheumatoid and juvenile idiopathic arthritis of the temporomandibular joint. Dtsch Arztebl Int. 2022;119(4):47\u201354. https:\/\/doi.org\/10.3238\/arztebl.m2021.0388.","journal-title":"Dtsch Arztebl Int"},{"issue":"1","key":"1358_CR24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5624\/isd.2018.48.1.1","volume":"48","author":"OM Rehan","year":"2018","unstructured":"Rehan OM, Saleh HAK, Raffat HA, Abu-Taleb NS. Osseous changes in the temporomandibular joint in rheumatoid arthritis: a cone-beam computed tomography study. Imaging Sci Dent. 2018;48(1):1\u20139. https:\/\/doi.org\/10.5624\/isd.2018.48.1.1.","journal-title":"Imaging Sci Dent"},{"issue":"1","key":"1358_CR25","doi-asserted-by":"publisher","first-page":"357","DOI":"10.13107\/jocr.2026.v16.i01.6700","volume":"16","author":"A Dhopte","year":"2026","unstructured":"Dhopte A, Dudhani SI, Vaniya CR, Shankar V, Bhatt S, Gupta S. Assessment of temporomandibular joint degeneration in rheumatoid arthritis patients using cone-beam computed tomography and musculoskeletal ultrasound. J Orthop Case Rep. 2026;16(1):357\u201365. https:\/\/doi.org\/10.13107\/jocr.2026.v16.i01.6700.","journal-title":"J Orthop Case Rep"},{"issue":"5","key":"1358_CR26","doi-asserted-by":"publisher","first-page":"630","DOI":"10.11607\/ijp.8145","volume":"36","author":"VF Mesic","year":"2023","unstructured":"Mesic VF, Laskarin AM, Kehler T, Spalj S, Dozet M, Pavicic DK. Characteristics of temporomandibular disorders and orofacial pain in individuals with rheumatoid arthritis. Int J Prosthodont. 2023;36(5):630\u20136. https:\/\/doi.org\/10.11607\/ijp.8145.","journal-title":"Int J Prosthodont"},{"issue":"3","key":"1358_CR27","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1007\/s10266-024-01033-w","volume":"113","author":"SR Oliveira","year":"2025","unstructured":"Oliveira SR, de Arruda JAA, Schneider AH, Ferreira GA, Calderaro DC, Costa FO, et al. Does non-surgical periodontal treatment contribute to rheumatoid arthritis amelioration? Evidence based on an overview and meta-analysis. Odontology. 2025;113(3):903\u201317. https:\/\/doi.org\/10.1007\/s10266-024-01033-w.","journal-title":"Odontology"},{"issue":"6","key":"1358_CR28","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1111\/jre.12925","volume":"56","author":"J Zhang","year":"2021","unstructured":"Zhang J, Xu C, Gao L, Zhang D, Li C, Liu J. Influence of anti-rheumatic agents on the periodontal condition of patients with rheumatoid arthritis and periodontitis: a systematic review and meta-analysis. J Periodontal Res. 2021;56(6):1099\u2013115. https:\/\/doi.org\/10.1111\/jre.12925.","journal-title":"J Periodontal Res"},{"issue":"10","key":"1358_CR29","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1002\/acr.24622","volume":"74","author":"DS Silva","year":"2022","unstructured":"Silva DS, Costa F, Baptista IP, Santiago T, Lund H, Tarp S, et al. Evidence-based research on effectiveness of periodontal treatment in rheumatoid arthritis patients: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2022;74(10):1723\u201335. https:\/\/doi.org\/10.1002\/acr.24622.","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"12","key":"1358_CR30","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12124128","volume":"12","author":"D Kreher","year":"2023","unstructured":"Kreher D, Ernst BLV, Ziebolz D, Haak R, Ebert T, Schmalz G. Dental caries in adult patients with rheumatoid arthritis-a systematic review. J Clin Med. 2023;12(12):4128. https:\/\/doi.org\/10.3390\/jcm12124128.","journal-title":"J Clin Med"},{"issue":"12","key":"1358_CR31","doi-asserted-by":"publisher","first-page":"7019","DOI":"10.1007\/s00784-023-05305-7","volume":"27","author":"E Karata\u015f","year":"2023","unstructured":"Karata\u015f E, Kul A, Camilleri J, Yonel Z. Association between rheumatoid arthritis and pulpal-periapical pathology: a systematic review. Clin Oral Investig. 2023;27(12):7019\u201328. https:\/\/doi.org\/10.1007\/s00784-023-05305-7.","journal-title":"Clin Oral Investig"},{"issue":"3","key":"1358_CR32","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1111\/scd.12575","volume":"41","author":"E Magdy","year":"2021","unstructured":"Magdy E, Ali S. Stratification of methotrexate-induced oral ulcers in rheumatoid arthritis patients. Spec Care Dentist. 2021;41(3):367\u201371. https:\/\/doi.org\/10.1111\/scd.12575.","journal-title":"Spec Care Dentist"},{"issue":"9","key":"1358_CR33","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.46290","volume":"15","author":"R Shrestha","year":"2023","unstructured":"Shrestha R, Ojha SK, Jha SK, Jasraj R, Fauzdar A. Methotrexate-induced mucositis: a consequence of medication error in a rheumatoid arthritis patient. Cureus. 2023;15(9):e46290. https:\/\/doi.org\/10.7759\/cureus.46290.","journal-title":"Cureus"},{"issue":"1","key":"1358_CR34","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1177\/08971900241276077","volume":"38","author":"R Hosseini","year":"2025","unstructured":"Hosseini R, Brooks SP, Gadelha E, Schaap R, Cook J, Husan A. Effective treatment of Methotrexate induced oral mucositis with a Morphine mouthwash solution: a case report. J Pharm Pract. 2025;38(1):212\u20136. https:\/\/doi.org\/10.1177\/08971900241276077.","journal-title":"J Pharm Pract"},{"issue":"3","key":"1358_CR35","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1007\/s10067-025-07356-5","volume":"44","author":"N Hammam","year":"2025","unstructured":"Hammam N, El-Hadidi T, El-Hadidi K, Elsaman A, El-Bakry SA, Nassr M, et al. International overview on juvenile-, adult- and elderly-onset rheumatoid arthritis: the age at disease onset as a fundamental determinant of clinical presentation. Clin Rheumatol. 2025;44(3):979\u201388. https:\/\/doi.org\/10.1007\/s10067-025-07356-5.","journal-title":"Clin Rheumatol"},{"issue":"3","key":"1358_CR36","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1590\/s1806-83242010000300018","volume":"24","author":"CH Pedrazas","year":"2010","unstructured":"Pedrazas CH, Azevedo MN, Torres SR. Oral events related to low-dose methotrexate in rheumatoid arthritis patients. Braz Oral Res. 2010;24(3):368\u201373. https:\/\/doi.org\/10.1590\/s1806-83242010000300018.","journal-title":"Braz Oral Res"},{"issue":"5","key":"1358_CR37","doi-asserted-by":"publisher","first-page":"e245","DOI":"10.1016\/j.oooo.2018.06.009","volume":"126","author":"B Zembiec-Wheeler","year":"2018","unstructured":"Zembiec-Wheeler B, Lott-Limbach A, Malmstr\u00f6m H, Elad S. Oral lichenoid reactions may possibly be associated with abatacept: a case report and literature update. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;126(5):e245\u201351. https:\/\/doi.org\/10.1016\/j.oooo.2018.06.009.","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"1358_CR38","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.intimp.2019.05.028","volume":"73","author":"EM Ahmed","year":"2019","unstructured":"Ahmed EM, Ali S, Gaafar SM, Rashed LM, Fayed HL. Evaluation of topical human platelet lysate versus topical clobetasol in management of methotrexate-induced oral ulceration in rheumatoid arthritis patients: randomized-controlled clinical trial. Int Immunopharmacol. 2019;73:389\u201394. https:\/\/doi.org\/10.1016\/j.intimp.2019.05.028.","journal-title":"Int Immunopharmacol"},{"issue":"3","key":"1358_CR39","doi-asserted-by":"publisher","first-page":"360","DOI":"10.33314\/jnhrc.v18i3.2743","volume":"18","author":"S Nakarmi","year":"2020","unstructured":"Nakarmi S, Pudasaini K, Adhikari B, Vaidya B. Adverse events profile of low-dose methotrexate in Nepalese patients with rheumatoid arthritis: an observational study. J Nepal Health Res Counc. 2020;18(3):360\u20135. https:\/\/doi.org\/10.33314\/jnhrc.v18i3.2743.","journal-title":"J Nepal Health Res Counc"},{"issue":"12","key":"1358_CR40","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.32268","volume":"14","author":"AY Aloyouny","year":"2022","unstructured":"Aloyouny AY, Almufarji F, Almutairi GG, Alkait S, Al-Mohaya MA, Alserwi R. Impact of rheumatic diseases on oral health-related quality of life. Cureus. 2022;14(12):e32268. https:\/\/doi.org\/10.7759\/cureus.32268.","journal-title":"Cureus"},{"issue":"5","key":"1358_CR41","doi-asserted-by":"publisher","first-page":"e28","DOI":"10.1016\/j.oooo.2012.12.008","volume":"115","author":"M Troeltzsch","year":"2013","unstructured":"Troeltzsch M, von Blohn G, Kriegelstein S, Woodlock T, Gassling V, Berndt R, et al. Oral mucositis in patients receiving low-dose methotrexate therapy for rheumatoid arthritis: report of 2 cases and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115(5):e28-33. https:\/\/doi.org\/10.1016\/j.oooo.2012.12.008.","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"issue":"5","key":"1358_CR42","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1007\/BF02229648","volume":"15","author":"A Ince","year":"1996","unstructured":"Ince A, Yazici Y, Hamuryudan V, Yazici H. The frequency and clinical characteristics of methotrexate (MTX) oral toxicity in rheumatoid arthritis (RA): a masked and controlled study. Clin Rheumatol. 1996;15(5):491\u20134. https:\/\/doi.org\/10.1007\/BF02229648.","journal-title":"Clin Rheumatol"},{"issue":"5","key":"1358_CR43","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1136\/ard.58.5.288","volume":"58","author":"MM Gordon","year":"1999","unstructured":"Gordon MM, Porter DR, Capell HA. Does sulphasalazine cause drug induced systemic lupus erythematosus? No effect evident in a prospective randomised trial of 200 rheumatoid patients treated with sulphasalazine or auranofin over five years. Ann Rheum Dis. 1999;58(5):288\u201390. https:\/\/doi.org\/10.1136\/ard.58.5.288.","journal-title":"Ann Rheum Dis"},{"issue":"10","key":"1358_CR44","doi-asserted-by":"publisher","first-page":"1102","DOI":"10.1093\/rheumatology\/39.10.1102","volume":"39","author":"SM Griffith","year":"2000","unstructured":"Griffith SM, Fisher J, Clarke S, Montgomery B, Jones PW, Saklatvala J, et al. Do patients with rheumatoid arthritis established on methotrexate and folic acid 5 mg daily need to continue folic acid supplements long term? Rheumatology (Oxford). 2000;39(10):1102\u20139. https:\/\/doi.org\/10.1093\/rheumatology\/39.10.1102.","journal-title":"Rheumatology (Oxford)"},{"issue":"1","key":"1358_CR45","first-page":"59","volume":"24","author":"I Cavazzana","year":"2006","unstructured":"Cavazzana I, Franceschini F, Quinzanini M, Manera C, Del Papa N, Maglione W, et al. Anti-Ro\/SSA antibodies in rheumatoid arthritis: clinical and immunologic associations. Clin Exp Rheumatol. 2006;24(1):59\u201364.","journal-title":"Clin Exp Rheumatol"},{"issue":"4-5","key":"1358_CR46","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.curtheres.2012.06.001","volume":"73","author":"CZ Ding","year":"2012","unstructured":"Ding CZ, Yao Y, Feng XB, Fang Y, Zhao C, Wang Y. Clinical analysis of Chinese patients with rheumatoid arthritis treated with leflunomide and methotrexate combined with different dosages of glucocorticoid. Curr Ther Res Clin Exp. 2012;73(4\u20135):123\u201333. https:\/\/doi.org\/10.1016\/j.curtheres.2012.06.001.","journal-title":"Curr Ther Res Clin Exp"},{"issue":"4","key":"1358_CR47","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1007\/s00296-012-2465-6","volume":"33","author":"T Kanzaki","year":"2013","unstructured":"Kanzaki T, Kawahata K, Kanda H, Fujio K, Kubo K, Akahira L, et al. Long-term therapeutic effects and safety of tacrolimus added to methotrexate in patients with rheumatoid arthritis. Rheumatol Int. 2013;33(4):871\u20137. https:\/\/doi.org\/10.1007\/s00296-012-2465-6.","journal-title":"Rheumatol Int"},{"issue":"10","key":"1358_CR48","doi-asserted-by":"publisher","first-page":"3930","DOI":"10.1093\/rheumatology\/keab917","volume":"61","author":"AA Sherbini","year":"2022","unstructured":"Sherbini AA, Gwinnutt JM, Hyrich KL, RAMS Co-Investigators, Verstappen SMM. Rates and predictors of methotrexate-related adverse events in patients with early rheumatoid arthritis: results from a nationwide UK study. Rheumatology (Oxford). 2022;61(10):3930\u20138. https:\/\/doi.org\/10.1093\/rheumatology\/keab917.","journal-title":"Rheumatology (Oxford)"},{"issue":"5","key":"1358_CR49","doi-asserted-by":"publisher","first-page":"e263","DOI":"10.1016\/S2665-9913(23)00089-9","volume":"5","author":"PG Conaghan","year":"2023","unstructured":"Conaghan PG, Nowak M, Du S, Luo Y, Landis J, Pachai C, et al. Evaluation of BMS-986142, a reversible Bruton\u2019s tyrosine kinase inhibitor, for the treatment of rheumatoid arthritis: a phase 2, randomised, double-blind, dose-ranging, placebo-controlled, adaptive design study. Lancet Rheumatol. 2023;5(5):e263\u201373. https:\/\/doi.org\/10.1016\/S2665-9913(23)00089-9.","journal-title":"Lancet Rheumatol"},{"issue":"2","key":"1358_CR50","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-025-06159-x","volume":"29","author":"A Abdelaziz","year":"2025","unstructured":"Abdelaziz A, Shamma RN, Fayed HL, Ali S. Rebamipide for management of methotrexate-induced oral ulcers: a three-arm randomized clinical trial. Clin Oral Investig. 2025;29(2):106. https:\/\/doi.org\/10.1007\/s00784-025-06159-x.","journal-title":"Clin Oral Investig"},{"key":"1358_CR51","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-018-0611-x","volume":"18","author":"Z Munn","year":"2018","unstructured":"Munn Z, Peters MDJ, Stern C, et al. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018;18:143. https:\/\/doi.org\/10.1186\/s12874-018-0611-x.","journal-title":"BMC Med Res Methodol"},{"key":"1358_CR52","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-021-01821-3","volume":"10","author":"MDJ Peters","year":"2021","unstructured":"Peters MDJ, Marnie C, Colquhoun H, et al. Scoping reviews: reinforcing and advancing the methodology and application. Syst Rev. 2021;10:263. https:\/\/doi.org\/10.1186\/s13643-021-01821-3.","journal-title":"Syst Rev"},{"issue":"10","key":"1358_CR53","doi-asserted-by":"publisher","first-page":"10652","DOI":"10.21037\/apm-21-2471","volume":"10","author":"X Jiang","year":"2021","unstructured":"Jiang X, Zeng J, Chen F, Li J. Systematic review and meta-analysis on the efficacy of methotrexate in rheumatoid arthritis. Ann Palliat Med. 2021;10(10):10652\u201360. https:\/\/doi.org\/10.21037\/apm-21-2471.","journal-title":"Ann Palliat Med"},{"key":"1358_CR54","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1016\/j.ejmech.2018.09.027","volume":"158","author":"W Wang","year":"2018","unstructured":"Wang W, Zhou H, Liu L. Side effects of methotrexate therapy for rheumatoid arthritis: a systematic review. Eur J Med Chem. 2018;158:502\u201316. https:\/\/doi.org\/10.1016\/j.ejmech.2018.09.027.","journal-title":"Eur J Med Chem"},{"issue":"1","key":"1358_CR55","doi-asserted-by":"publisher","first-page":"33","DOI":"10.17159\/sadj.v80i01.20071","volume":"80","author":"J Fourie","year":"2025","unstructured":"Fourie J, Laubscher D, Simelane T. Methotrexate-induced oral mucositis in patients with rheumatoid arthritis: a case series and literature review. S Afr Dent J. 2025;80(1):33\u201341. https:\/\/doi.org\/10.17159\/sadj.v80i01.20071.","journal-title":"S Afr Dent J"},{"key":"1358_CR56","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-024-02167-x","volume":"29","author":"MS Hosseini","year":"2024","unstructured":"Hosseini MS, Sanaie S, Mahmoodpoor A, et al. Cancer treatment-related xerostomia: basics, therapeutics, and future perspectives. Eur J Med Res. 2024;29:571. https:\/\/doi.org\/10.1186\/s40001-024-02167-x.","journal-title":"Eur J Med Res"},{"issue":"11","key":"1358_CR57","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.73179","volume":"16","author":"RN Hammad","year":"2024","unstructured":"Hammad RN, Ahmad SA, Rasool MI. Impact of biologic and disease-modifying anti-rheumatic drug (DMARD) therapies on oral health in rheumatologic patients: a case-control study. Cureus. 2024;16(11):e73179. https:\/\/doi.org\/10.7759\/cureus.73179.","journal-title":"Cureus"},{"issue":"6","key":"1358_CR58","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1007\/s10067-020-05004-8","volume":"39","author":"LR Harrold","year":"2020","unstructured":"Harrold LR, Shan Y, Rebello S, Kramer N, Connolly SE, Alemao E, et al. Prevalence of Sj\u00f6gren\u2019s syndrome associated with rheumatoid arthritis in the USA: an observational study from the Corrona registry. Clin Rheumatol. 2020;39(6):1899\u2013905. https:\/\/doi.org\/10.1007\/s10067-020-05004-8.","journal-title":"Clin Rheumatol"},{"key":"1358_CR59","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1443455","volume":"15","author":"Y Dong","year":"2024","unstructured":"Dong Y, Wang T, Wu H. The role of cytokines from salivary gland epithelial cells in the immunopathology of Sj\u00f6gren\u2019s syndrome. Front Immunol. 2024;15:1443455. https:\/\/doi.org\/10.3389\/fimmu.2024.1443455.","journal-title":"Front Immunol"},{"issue":"25","key":"1358_CR60","doi-asserted-by":"publisher","first-page":"01164","DOI":"10.1016\/j.oooo.2025.08.008","volume":"S2212\u20134403","author":"CPES Coelho","year":"2025","unstructured":"Coelho CPES, da Silva JR, Marques RCR, Melo JLMA, Alves LM, Melo CDCO, et al. Salivary flow and aging: a cross-sectional estimate of the annual decline per year of age. Oral Surg Oral Med Oral Pathol Oral Radiol. 2025;S2212\u20134403(25):01164\u201372. https:\/\/doi.org\/10.1016\/j.oooo.2025.08.008.","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"issue":"2","key":"1358_CR61","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1177\/23800844211012678","volume":"7","author":"JLP Protudjer","year":"2022","unstructured":"Protudjer JLP, Billedeau C, Hurst K, Schroth R, Stavropoulou C, Kelekis-Cholakis A, et al. Oral health in rheumatoid arthritis: listening to patients. JDR Clin Transl Res. 2022;7(2):127\u201334. https:\/\/doi.org\/10.1177\/23800844211012678.","journal-title":"JDR Clin Transl Res"}],"container-title":["Odontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10266-026-01358-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10266-026-01358-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10266-026-01358-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T18:14:43Z","timestamp":1773166483000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10266-026-01358-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":61,"alternative-id":["1358"],"URL":"https:\/\/doi.org\/10.1007\/s10266-026-01358-8","relation":{},"ISSN":["1618-1247","1618-1255"],"issn-type":[{"value":"1618-1247","type":"print"},{"value":"1618-1255","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,10]]},"assertion":[{"value":"3 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}