How does methotrexate affect a patient undergoing extraction?

Correct answer: C. Delayed wound healing

• A. Incorrect. Methotrexate impairs rather than accelerates tissue regeneration.
• B. Incorrect. Methotrexate may cause thrombocytopenia through marrow suppression, reducing rather than enhancing haemostatic capacity.
• C. Correct. Methotrexate is a folate antagonist that inhibits DNA synthesis in rapidly dividing cells. This impairs epithelial and fibroblast proliferation, delaying healing. It also causes myelosuppression (raising infection and bleeding risk) and oral ulceration/mucositis.
• D. Incorrect. It does not increase salivary flow; oral dryness and ulceration are more typical.