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Seropositivity combined with smoking is associated with increased prevalence of periodontitis in patients with rheumatoid arthritis
  1. Kaja Eriksson1,
  2. Lena Nise2,
  3. Lars Alfredsson2,3,
  4. Anca Irinel Catrina4,
  5. Johan Askling4,5,
  6. Karin Lundberg4,
  7. Lars Klareskog4,
  8. Tülay Yucel-Lindberg1
  1. 1 Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
  2. 2 Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  3. 3 Centre of Environmental and Occupational Medicine, Stockholm County Council, Stockholm, Sweden
  4. 4 Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden
  5. 5 Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr Tülay Yucel-Lindberg and Dr Kaja Eriksson, Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Box 4064, SE-141 04 Huddinge, Sweden; tulay.lindberg{at}ki.se, Kaja.eriksson{at}ki.se

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An association between periodontitis and rheumatoid arthritis (RA) has been proposed based on observations of increased risk of periodontitis in patients with RA as well as the presence of antibodies to citrullinated protein antigens (ACPAs) and rheumatoid factor (RF) in serum and gingiva of patients with periodontitis.1–3 Additionally, smoking is one of the most important risk factors for both periodontitis and RA, and predispose for the development of seropositive RA.4–6 We have previously reported that smokers with RA have increased prevalence of periodontitis as compared with never smokers in the Swedish population-based case–control study EIRA (Epidemiological Investigation of Rheumatoid Arthritis).7 The objective of the current study was to further investigate the effects of smoking on the risk of periodontitis in seropositive and seronegative (ACPA/RF) subsets of RA.

Data on periodontal status (years 2008–2012) were retrieved from the Swedish Dental Health Registry (DHR) for 2327 patients with established RA (1469/852 ACPA-positive/ACPA-negative and 1505/822 RF-positive/RF-negative, respectively) included in the EIRA study (years 1996–2009) as previously described.7 Periodontal diagnosis was based on diagnostic codes for periodontitis, peri-implantitis and …

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