DNAI · ORVS · Oral Risk Verification

Every DMARD carries oral risk.
ORVS surfaces it before it surfaces in the patient.

Pre-biologic dental clearance, DMARD oral side-effect flags, and monitoring schedules — grounded in Dr. Erick Zamora's actual prescribing practice for rheumatology.

Request clinical access Read the brief
Proof of concept · In clinical evaluation · Dr. Erick Zamora
ORVS · Verificación de Riesgo Oral · Dr. Zamora En uso

Perfil farmacológico

Ana L. · 47 años · F · AR refractaria Candidata a biológico (RTX). MTX 20 mg/sem + SSZ 2 g/d actuales. Evaluación pre-biológico.

Medicamentos activos

Metotrexato 20 mg/sem · Sulfasalazina 2 g/d · Prednisona 5 mg/d

Laboratorio

Estado dental

Pendiente

Úlceras MTX

Sí (leves)

Xerostomía

Moderada

Ácido fólico

Sin prescribir

Verificación pre-biológico

Bloqueado · Dental Clearance dental requerido antes de RTX Rituximab: riesgo ONM con infecciones dentales activas. Evaluación odontológica mandatoria antes de primera dosis.
Acción requerida Prescribir ácido fólico con MTX MTX 20 mg/sem sin ácido fólico. Riesgo de mucositis y úlceras orales. 5 mg/sem AF reduce eventos hasta 80%.
Monitorear Xerostomía por SSZ — evaluación Sjögren Xerostomía con SSZ: descartar Sjögren secundario. Si confirmado, ajuste de plan hidratante.

Checklist pre-RTX

Evaluación odontológica: infecciones, extracciones pendientes, prótesis

Esperar 2 semanas post-procedimiento dental antes de RTX

Iniciar ácido fólico 5 mg/sem con próxima dosis MTX

Revisión de xerostomía a las 4 semanas post-RTX

"We were missing dental clearance on biologic candidates. ORVS built the checklist into the workflow — not as a reminder, as a gate."

Dr. Erick Zamora - Rheumatologist · Primary operator

4 of 7 products
in the DNAI
proof stack

DMARDs and biologics damage the oral environment. That damage is preventable.

Pre-biologic gap

Dental clearance before biologics is mandatory — and frequently missed.

Rituximab, anti-TNF, and IL-6 inhibitors carry infection risk that active dental disease amplifies. ORVS builds the clearance gate into the prescription workflow.

Methotrexate

MTX causes oral ulcers when folic acid is not co-prescribed.

Up to 30% of patients on MTX develop oral ulcers. Folic acid co-prescription reduces this to under 5%. ORVS flags missing folic acid before the prescription is written.

Drug interactions

Oral side-effect profiles overlap and compound.

Hydroxychloroquine and SSZ together increase xerostomia risk. ORVS surfaces the compound oral risk of the current regimen, not each drug in isolation.

How ORVS works.

01

Enter the active medication regimen.

Current DMARDs, biologics, corticosteroids, and adjuncts. ORVS maps the complete oral risk profile of the regimen — not individual drugs, but the combination the patient is actually taking.

02

Surface oral risks and missing preventive steps.

Missing folic acid with MTX, dental clearance requirement for biologics, xerostomia risk combinations, candidiasis risk from corticosteroids, HCQ-related salivary gland effects. Each risk with clinical evidence.

03

Generate the oral monitoring schedule.

Pre-biologic dental clearance timeline, folic acid prescription, xerostomia management protocol, candidiasis prophylaxis if indicated. Structured output for the clinical record.

Clinical capabilities

What ORVS verifies.

Current capabilities

  • Pre-biologic dental clearance checklist (RTX, anti-TNF, IL-6, IL-17 inhibitors)
  • Methotrexate oral toxicity flag + folic acid co-prescription verification
  • Xerostomia risk assessment from DMARD + biologic combinations
  • Candidiasis risk flag with corticosteroid use
  • HCQ salivary gland effect monitoring
  • ONM risk screening for patients on bisphosphonates
  • Drug-oral interaction matrix for common DMARD combinations
  • Post-procedure dental clearance timeline before biologic dosing

Access status

Proof of concept in active clinical evaluation.

ORVS is in clinical evaluation by Dr. Erick Zamora. Access available to rheumatologists managing patients on DMARDs and biologics who want systematic oral risk verification.

Request clinical access Read the DNAI brief first

Part of the DNAI proof stack

ORVS LES AI RheumaAI RheumaScore Beach Science / clawRxiv STORM BiobadamexAI

Common questions.

Is this a dentistry tool?

No. ORVS is a rheumatology tool. It surfaces oral risks from the medications a rheumatologist prescribes, and generates the pre-biologic checklist and monitoring schedule. The rheumatologist acts on the flags — ORVS does not replace the dental evaluation, it identifies when one is required.

Which biologics require dental clearance?

Rituximab is the highest priority — dental infections dramatically increase ONM risk. Anti-TNF agents, IL-6 inhibitors, and IL-17 inhibitors also require pre-treatment dental screening. ORVS surfaces the specific clearance protocol for each class.

What does it do with methotrexate?

It checks whether folic acid is co-prescribed at the correct dose (5 mg/week for MTX ≥ 15 mg/week), flags oral ulcer reports and correlates them with MTX dose and folate status, and suggests dose adjustment thresholds when ulcers are recurrent.

Can it handle combination therapy?

Yes. ORVS evaluates the compound oral risk of the full regimen, not individual drugs. Combined SSZ + HCQ xerostomia, MTX + leflunomide hepatotoxicity with oral manifestations, corticosteroid + MTX candidiasis risk — all evaluated together.