Periodontitis and Rheumatoid Arthritis. A case-control study

Abstract

Background: Periodontitis and Rheumatoid Arthritis (RA) are immunoinflammatory diseases that share etiological mechanisms in their onset and development. Objective: To evaluate the bidirectional relationship between them.
Material and Methods: In 150 participants, sociodemographic variables, clinical attachment loss (CAL), probing depth (PD), bleeding on probing (BoP), rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPA), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were assessed. Additionally, arthritis activity was evaluated using the Disease Activity Score 28 and the Health Assessment Questionnaire. Initially, we analyzed the characteristics of the sample and associated different oral health. Finally, a logistic regression model was developed with rheumatoid arthritis status as the primary outcome.
Results: It was observed that patients with RA had a higher prevalence of periodontitis (p= 0.026), fewer present teeth (p<0.001), a higher number of sites with BoP (p=0.02), and more sites with PD = 4 mm and CAL ≥3 mm (p<0.001) compared to the group without RA. Additionally, when comparing patients with and without periodontitis, the periodontitis patients had a higher occurrence of RA than those without periodontitis (73.3% versus 26.7%, p=0.026). In the multivariate regression model, sites with PD = 4 mm and CAL ≥ 3 mm (OR 1.08, p<0.001), age (OR 1.07, p< 0.001), and CRP (OR 1.07, p=0.031) remained significant for the presence of RA.
Conclusions: Our results show worse oral health in patients with RA. It is also concluded that periodontal indicators negatively impact RA activity.