What is known and objective: The frequent tenofovir disoproxil fumarate (TDF)-related adverse drug reactions (ADRs) are nephrotoxicity and bone toxicity; however, tooth-related ADRs of TDF have not been reported. We describe the case of a 41-year-old Han Chinese man with chronic hepatitis B with TDF-associated tooth loss.

Case summary: He presented with halitosis, gingival swelling and tooth loss after TDF use. After excluding the possibility of other drug-related ADRs, TDF was considered a possible cause and switched with tenofovir alafenamide fumarate (TAF). After 6 months, the oral symptoms disappeared, with no additional tooth loss.

What is new and conclusion: This is the first report of such ADRs. The ADR score was 7, indicating tooth loss as a potential TDF-related ADR.

Keywords: adverse reaction; chronic hepatitis B; tenofovir alafenamide fumarate; tenofovir disoproxil fumarate.