Background Several studies have shown a higher degree of periodontal disease (PD) in patients with rheumatoid arthritis (RA) than in general population. This fact could be attributed to the functional impairment caused by the disease. To evaluate this hypothesis, we included disability indicators in this study.
Objectives To investigate whether the degree of EP is related to functional impairment in patients with RA.
Methods Transversal study comparing two groups: patients with RA (ACR criteria), and a control group without inflammatory joint disease. At baseline, a rheumatologist performed a clinical examination to RA patients. Within a 20 days period, they were checked by a dentist, who also examined the control group. The variables collected for all subjects included in the study were the following: age, sex, alcohol intake, smoking habit, oral hygiene as measured by the plaque index (PI) and the bleeding index (BI); mean periodontal bursae (MPB), and mean attachment loss (MAL), as markers of periodontitis. We considered the existence of periodontitis if MPB >2 mm and MAL >3 mm. The degree of PD was graded as mild (MAL 1-2 mm), moderate (MAL 3-4 mm), or severe (MAL ≥5), based on the classification of the American Academy of Periodontology. The following data were also compiled for the RA group of patients: degree of activity (DAS28), RF and CCP antibodies positivity, duration of the disease, presence of erosions, association with Sjögren's Syndrome, treatment (corticosteroids, DMARDs and/or biological therapies), HAQ and Cochin Rheumatoid Arthritis Hand Functional Scale (CRAHFS). The CRAHFS is a questionnaire which measures the degree of hand disability, and includes 18 questions scoring 0-5. We used SPSS 17.0 for descriptive statistics. For inferential statistics, Chi-square, U Mann Whitney and Rho Spearman were used.
Results A set of 38 RA patients and 40 control subjects were included. We only found differences between both groups in gender (women: 81.6% AR vs. 50% control, p 0.004) and in the PI (the RA patients had poorer oral hygiene than healthy controls, p 0.000). Although we did not found differences in the prevalence of periodontitis, a higher degree of periodontal disease was found in the RA group (p 0.041). We also found a good correlation between the IP, as a marker of oral hygiene, and the HAQ in the RA group, but the correlation with CRAHFS did not reach statistical significance (see Table 1).
Conclusions The overall functional impairment, and not just hand's disability, is responsible for a worse oral hygiene and a greater degree of periodontal disease in patients with RA.
Disclosure of Interest None declared