Oral status in patients with early rheumatoid arthritis: a prospective, case–control study
TL;DR: Increased loss of periodontal attachment and alveolar bone can be detected in patients with ERA, therefore it is proposed that the consulting rheumatologists inform the patients that they have a higher risk ofperiodontal disease.
Abstract: Objective. Patients with RA suffer from a higher risk of periodontal attachment loss and increased oral inflammation. We hypothesize that there are pathogenetic and immunological interactions between these diseases that go beyond impaired manual dexterity accompanying advanced RA. The primary objective of the present study was to determine whether a loss of alveolar bone can be detected in RA patients during the early course of the disease. Methods. In this cross-sectional, epidemiological casecontrol study, 22 patients with early RA (ERA) were compared with 22 matched healthy controls. Oral and periodontal status, clinical activity, and sociodemographic parameters were determined. Oral microbiota were analysed using real-time quantitative PCR specific for leading oral pathogens. Results. More advanced forms of periodontitis were found in ERA patients compared with controls. ERA patients had a greater number of missing teeth [ERA 5.7 (S.D. 5.0), controls 1.9 (S.D. 1.0), P = 0.002], deeper periodontal pockets [clinical attachment level: ERA 3.4 (S.D. 0.5 mm), controls 2.7 (S.D. 0.3 mm), P < 0.000], and greater bleeding on probing [ERA 18.6% (S.D. 9.0%), controls 10.5% (S.D. 5.1%), P = 0.001] despite comparable oral hygiene. Tannerella forsythia (6.77-fold, P = 0.033) subgingivally and Streptococcus anginosus (3.56-fold, P = 0.028) supragingivally were the characteristic pathogens in ERA. Conclusion. Increased loss of periodontal attachment and alveolar bone can be detected in patients with ERA, therefore we propose that the consulting rheumatologists inform the patients that they have a higher risk of periodontal disease. It would be beneficial if these patients were referred directly for intensive dental care.
Cites background from "Oral status in patients with early ..."
...In the remainder of the studies, the most frequently reported treatment for rheumatoid arthritis included disease-modifying antirheumatic drugs (methotrexate, sulfasalazine, and leflunomide) [38, 39, 42, 43, 46, 51, 54, 56, 57, 59], biologic therapy (anti-TNF-α) [34, 38, 39, 42, 59], corticosteroids (prednisolone) [38, 42, 43, 46, 51, 54, 56, 59], and/or nonsteroidal anti-inflammatory drugs [43, 46–48, 51, 54, 57]....
...Among the selected trials, eight studies broached the epidemiological and clinical relationship of patients with PD and RA [38, 41, 44, 45, 49, 54, 56, 59], indicating a higher prevalence of PD in patients with RA, which have worse periodontal parameters....
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