Rheumatoid Arthritis Augments Periodontal Disease Risk

by VR Sreeraman on Oct 28 2008 4:29 PM

A new study suggests that rheumatoid arthritis sufferers may be at increased risk for periodontal disease - a gum disease characterized by inflammation that leads to separation of the teeth from the gums, loss of bony support, and possible tooth loss.

Study leader Dr. Clifton O. Bingham III, a rheumatologist from the Johns Hopkins University School of Medicine, revealed that the research team evaluated the prevalence of periodontal disease and other aspects of oral health in 153 patients with RA, who were already enrolled in a cardiovascular disease study.

The researcher said that 66 per cent of the patients were female, ranged in age from 45 to 84 years, were primarily Caucasian, and had, on average, suffered from RA for 11 years.

The subjects were administered oral health questionnaires that assessed their dental histories, oral hygiene practices, tooth loss, mouth dryness, and periodontal disease status of each patient.

Periodontal-specific questions included past diagnosis and treatment of periodontal disease, as well as self-reported gum recession due to gingivitis and bleeding and swelling of the gums.

The researchers used established RA criteria to look at the associations between the disease and periodontal symptoms, and estimated the prevalence of periodontal disease in the patients taking into consideration socio-demographic factors, lifestyle, and oral hygiene, as well as the presence of other diseases.

They observed that 82 per cent of the patients reported periodontal symptoms, including a history of the disease, gum recession, swollen gums and gum bleeding.

Further analyses by the researchers showed that the presence of periodontal disease was significantly associated with a patient's RA disease activity score, or DAS as it is commonly called, and with rheumatoid nodules.

Based on their observations, the researchers same to the conclusion that periodontal disease is independently associated with RA disease activity.

"These findings, along with prior studies and our additional preliminary data showing a high prevalence of moderate to severe periodontal disease in RA patients based on comprehensive oral examinations, strongly suggest an association between these two inflammatory diseases. We are now conducting a number of additional studies to better understand the pathobiologic mechanisms that may explain these associations," said Bingham III.

"It is notable that treatment of periodontal disease leads to improvement of other systemic conditions including diabetes, and may even lower cardiovascular risk. Thus it is possible that increased attention to oral health and treatment of periodontal disease may improve outcomes for patients with RA," the researcher added.

The study was presented at the American College of Rheumatology Annual Scientific Meeting in San Francisco, California.