Periodontitis is a severe gum disease initiated by bacterial infection between the teeth and supporting tissues. It can destroy alveolar bone and, in adults, is the most common tooth loss cause. Rheumatoid arthritis is a chronic autoimmune disease distinguished by inflammation of the synovium; severe disease leads to the destruction of bone and cartilage. In people with specific genetic backgrounds, RA is triggered by environmental factors such as infections and smoking. One such trigger may be periodontitis; increasing studies have suggested an association between periodontitis and RA.
Against the above background, Dr Mai Hussein, Harvard Medical School, Boston, MA, USA, and colleagues aimed to examine the association between periodontitis, tooth loss, and rheumatoid arthritis through a large national dataset.
For this purpose, the researchers performed an observational cross-sectional study using NHANES ( National Health and Nutrition Examination Survey) cycles (2009-2014). The participants filled out a questionnaire through which their rheumatoid arthritis status was detected. Periodontal status was assigned based on the periodontal pocket depth and clinical attachment level.
Dentition status was determined by the number of permanent teeth observed. The association between rheumatoid arthritis, moderate/severe periodontitis and non-functional dentition were examined. Rheumatoid arthritis was the exposure, and non-functional dentition and moderate/severe periodontitis were taken as outcomes.
The authors reported the following findings:
- Moderate/severe periodontitis was more prevalent in patients reporting rheumatoid arthritis (53% vs 41.5%).
- Non-functional dentition was more common in participants with rheumatoid arthritis (41% vs 15.5%).
- The fully adjusted model revealed that rheumatoid arthritis patients had higher odds of developing a non-functional dentition (Odds Ratio 1.8) but no association with moderate/severe periodontitis (Prevalence Ratio 1.01).
"Rheumatoid arthritis was linked with a higher chance of having non-functional dentition," the researchers wrote. "Still, it did not show an association with periodontitis after adjustment of risk factors to control their confounding effect."
Reference:
The study, "Differential Associations of Rheumatoid Arthritis and Periodontitis or Tooth Loss: A Cross-Sectional Study," was published in the Journal of Clinical Periodontology. DOI: https://doi.org/10.1111/jcpe.13757
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