The prevalence of periodontitis in patients with rheumatoid arthritis: A cross-sectional analytical study in population of Pakistan

Mehroz Ahmad Khan; Hira Asghar; Mouz Kashir; Ammar Abdullah Malik; Hammad Waseem Baig; Hafiz Muhammad Shahzad Khurshid

doi:10.53730/ijhs.v7nS1.14226

Authors

Mehroz Ahmad Khan BDS, RDS, General Dentist, Associate Dentist, Al-Khidmat Hospital, Sahiwal Pakistan
Hira Asghar B.Sc, BDS, M.Phil (Dental Materials), Associate Professor, Department of Science of Dental Materials, Azra Naheed Dental College, Superior University, Lahore Pakistan
Mouz Kashir
muaaz.iqbal@gmail.com
BDS Final Year Student, Akhtar Saeed Medical and Dental College, Lahore Pakistan
Ammar Abdullah Malik BDS, M.Phil (Oral Biology), Assistant Professor, Department of Oral Biology, Foundation University College of Dentistry, Foundation University, Islamabad Pakistan
Hammad Waseem Baig BDS, RDS, House Surgeon, Akhtar Saeed Medical and Dental College, Lahore Pakistan
Hafiz Muhammad Shahzad Khurshid B.Sc, BDS, M.Phil (Oral Pathology), Assistant Professor, Department of Oral Pathology, Bakhtawar Amin Medical and Dental College, Multan Pakistan

Keywords:

rheumatoid arthritis, periodontitis, prevalence, inflammation, plaque score

Abstract

Background and Aim: Rheumatoid arthritis (RA) patients are more susceptible to the initiation of severe periodontitis which can ultimately intensify their systemic inflammation associated with RA. The present study aimed to determine the incidence of periodontitis in rheumatoid arthritis patients. Materials and Methodology: A cross-sectional analytical study was carried out on 168 rheumatoid arthritis patients in the Department of Dentistry and Internal Medicine of a Tertiary Care Hospital of Lahore, Pakistan from January 2022 to December 2022. All the patients were inquired about their demographic details, medical history and smoking habits. A detailed periodontal examination of full mouth was done and plaque index, clinical attachment level (CAL) and probing pocket depth (PPD) was measured. Rheumatoid factor (RF)’s presence, number of tender and swollen joints, erythrocyte sedimentation rate (ESR); Disease Activity Index (DAS) and hand radiographs were the different RA parameters which were recorded. Periodontal conditions were then associated and correlated with RA parameters. Results: Out of the total 168 RA patients, there were 142 (84.5%) females and 26 (15.5%) male patients. The overall mean age was 48.6 ± 8.64 years. The overall mean DAS score and disease duration was 4.58 ± 1.32 and 9.58 ± 6.8 years respectively.

Downloads

Download data is not yet available.

References

Susanto H, Nesse W, Kertia N, Soeroso J, Huijser van Reenen Y, Hoedemaker E, Agustina D, Vissink A, Abbas F, Dijkstra PU. Prevalence and severity of periodontitis in Indonesian patients with rheumatoid arthritis. Journal of periodontology. 2013 Aug;84(8):1067-74.

Białowąs K, Radwan-Oczko M, Duś-Ilnicka I, Korman L, Świerkot J. Periodontal disease and influence of periodontal treatment on disease activity in patients with rheumatoid arthritis and spondyloarthritis. Rheumatology international. 2020 Mar;40:455-63.

Monsarrat P, de Grado GF, Constantin A, Willmann C, Nabet C, Sixou M, Cantagrel A, Barnetche T, Mehsen-Cetre N, Schaeverbeke T, Arrive E. The effect of periodontal treatment on patients with rheumatoid arthritis: the ESPERA randomized controlled trial. Joint Bone Spine. 2019 Oct 1;86(5):600-9.

Zhao R, Gu C, Zhang Q, Zhou W, Feng G, Feng X, Dong C, Gu Z. Periodontal disease in Chinese patients with rheumatoid arthritis: A case–control study. Oral Diseases. 2019 Nov;25(8):2003-9.

Daalderop LA, Wieland BV, Tomsin K, Reyes L, Kramer BW, Vanterpool SF et al (2018) Periodontal disease and pregnancy outcomes: overview of systematic reviews. JDR Clin Trans Res 3:10–27

Egeberg A, Mallbris L, Gislason G, Hansen PR, Mrowietz U (2017) Risk of periodontitis in patients with psoriasis and psoriatic arthritis. J Eur Acad Dermatol Venereol 31:288–293

Nazurah Nik Eezammuddeen, Rathna Devi Vaithilingam, Norul Husna Mohammad Hassan, Influence of periodontitis on levels of auto antibodies in rheumatoid arthritis patients: A systematic review, Journal of Periodontal Research, 10.1111/jre.13065, 58, 1, (29-42), (2022).

Dimitra Karapetsa, Arianna Consensi, Giulia Castagnoli, Morena Petrini, Matteo Tonelli, Stefano Gennai, Laura Bazzichi, Filippo Graziani, Periodontitis in Italian patients with established rheumatoid arthritis: A cross‐sectional study, Oral Diseases, 10.1111/odi.13842, 28, 6, (1715-1722), (2021).

Egle Punceviciene, Adomas Rovas, Alina Puriene, Kristina Stuopelyte, Dalius Vitkus, Sonata Jarmalaite, Irena Butrimiene, Investigating the relationship between the severity of periodontitis and rheumatoid arthritis: a cross-sectional study, Clinical Rheumatology, 10.1007/s10067-021-05661-3, 40, 8, (3153-3160), (2021).

PoojaR Disale, SameerA Zope, Girish Suragimath, AlluriSiddhartha Varma, Apurva Pisal, Prevalence and severity of periodontitis in patients with established rheumatoid arthritis and osteoarthritis, Journal of Family Medicine and Primary Care, 10.4103/jfmpc.jfmpc_398_20, 9, 6, (2919), (2020).

Marcela F. Moura, Luís O. M. Cota, Tarcília A. Silva, Sheila C. Cortelli, Gilda A. Ferreira, Marina M. López, José R. Cortelli, Fernando O. Costa, Clinical and microbiological effects of non-surgical periodontal treatment in individuals with rheumatoid arthritis: a controlled clinical trial, Odontology, 10.1007/s10266-020-00566-0, 109, 2, (484-493), (2020).

Radwan-Oczko M, Jaworski A, Duś I, Plonek T, Szulc M, Kustrzycki W (2014) Porphyromonas gingivalis in periodontal pockets and heart valves. Virulence 5:575–580

Eriksson K, Nise L, Kats A, Luttropp E, Catrina AI, Askling J et al (2016) Prevalence of periodontitis in patients with established rheumatoid arthritis: a Swedish population based case-control study. PLoS One 11:e0155956.

Pischon N, Pischon T, Kroger J et al. (2008) Association among rheumatoid arthritis, oral hygiene, and periodontitis. J Periodontol 79, 979–86.

Dissick A, Redman RS, Jones M et al. (2010) Association of periodontitis with rheumatoid arthritis: a pilot study. J Periodontol 81, 223–30.

Susanto H, Nesse W, Kertia N et al. (2013) Prevalence and severity of periodontitis in indonesian patients with rheumatoid arthritis. J Periodontol 84, 1067–74.

Chen HH, Huang N, Chen YM et al. (2013) Association between a history of periodontitis and the risk of rheumatoid arthritis: a nationwide, population-based, case-control study. Ann Rheum Dis 72, 1206–11.

American College of Obstetricians and Gynecologists Women’s Health Care Physicians, Committee on Health Care for Underserved Women. 2013. Committee opinion No. 569: oral health care during pregnancy and through the lifespan. Obstet Gynecol. 122(2 Pt 1):417–22.

Aagaard K, Ma J, Antony KM, Ganu R, Petrosino J, Versalovic J. 2014. The placenta harbors a unique microbiome. Sci Transl Med. 6(237):237ra65.

Ao M, Miyauchi M, Furusho H, Inubushi T, Kitagawa M, Nagasaki A, Sakamoto S, Kozai K, Takata T. 2015. Dental infection of Porphyromonas gingivalis induces preterm birth in mice. PLoS One. 10(8):e0137249.

Blanc V, O’Valle F, Pozo E, Puertas A, Leon R, Mesa F. 2015. Oral bacteria in placental tissues: increased molecular detection in pregnant periodontitis patients. Oral Dis. 21(7):905–912.

Xiao F, Li C, Lin Y, Peng Z, Xu X, Wen Y, Huang N, Zhang P. Increased risk of periodontitis occurrence in patients with rheumatoid arthritis and its association with the levels of IL-1β and TNF-α in gingival crevicular fluid. Ann. Palliat. Med. 2021 Aug 1;10:9078-87.

Fuggle, N.R.; Smith, T.O.; Kaul, A.; Sofat, N. Hand to Mouth: A Systematic Review and Meta-Analysis of the Association between Rheumatoid Arthritis and Periodontitis. Front Immunol. 2016, 7, 80.

Janssen, K.M.; Vissink, A.; de Smit, M.J.; Westra, J.; Brouwer, E. Lessons to be learned from periodontitis. Curr. Opin. Rheumatol. 2013, 25, 241–247.

Hajishengallis, G. Periodontitis: From microbial immune subversion to systemic inflammation. Nat. Rev. Immunol. 2015, 15, 30–44.

Lee, J.H.; Lee, J.S.; Park, J.Y.; Choi, J.K.; Kim, D.W.; Kim, Y.T.; Choi, S.H. Association of Lifestyle-Related Co morbidities With Periodontitis: A Nationwide Cohort Study in Korea. Medicine (Baltimore) 2015, 94, e1567.