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Periodontal disease is significantly higher in non-smoking treatment-naive rheumatoid arthritis patients: results from a case-control study
  1. Damodaram Potikuri1,
  2. Kalyan Chakravarthy Dannana2,
  3. Suresh Kanchinadam1,
  4. Sumeet Agrawal1,
  5. Anuradha Kancharla1,
  6. Liza Rajasekhar1,
  7. Shantakumari Pothuraju2,
  8. Narsimulu Gumdal1
  1. 1Department of Rheumatology, Nizam's Institute of Medical Sciences, Hyderabad, India
  2. 2Department of Periodontia, Government Dental College, Hyderabad, India
  1. Correspondence to Dr G Narsimulu, Department of Rheumatology, Nizam's Institute of Medical Sciences, Hyderabad 500082, India; narsimuluhyderabad{at}


Objective To find the strength of association between periodontal disease (PD) and rheumatoid arthritis (RA) in non-smoking, disease modifying antirheumatic drug (DMARD)-naive RA patients in a case-control design.

Methods Patients of RA (DMARD-naive, non-smokers) satisfying the American college of Rheumatology 1987 criteria and healthy controls were included. PD was defined as present if the mean pocket depth (MPD) is ≥3 mm. Demographic data and disease specific variables were recorded for RA patients and healthy controls. Titres of immunoglobulin M-rheumatoid factor (IgM-RF) and anticitrullinated peptide antibodies (ACPAs) were measured using ELISA.

Results Patients with RA (n=91) had a 4.28 (CI 2.35 to 7.38) higher odds of PD (64.8% vs 28%, p<0.001) compared with healthy controls (n=93). The MPD was 3.61±1.22 mm in cases and 2.46±0.74 mm in controls (p<0.001). IgM-RF titres (110.56±95.81 vs 66.53±70.29; p=0.02) and ACPA titres (753.05±1088.27 vs 145.15±613.16, p=0.001) were significantly higher in RA patients with PD than those without PD. The MPD positively correlated with titres of ACPAs in RA patients (r=0.24; p=0.02).

Conclusions PD is more frequent and severe in non-smoking DMARD-naive RA patients compared with healthy controls. PD in RA is associated with high titres of ACPAs.

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  • Funding Indian Council of Medical Research (ICMR).

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Approval provide by the Ethical committee Board of the Nizam's Institute of Medical Sciences.

  • Provenance and peer review Not commissioned; externally peer reviewed.