449 Periodontitis as a risk factor for psoriasis

Abstract

Patients with psoriasis have an increased risk for inflammatory periodontal disease, however, data are sparse. Inflammatory disorders are well known to trigger psoriasis. We examined the periodontal status in 50 patients with psoriasis compared to 25 healthy control individuals. We examined whether there is (1) an enhanced periodontal risk, (2) increased IL-1 mediated inflammation, (3) increased bacterial load, (4) sufficient oral hygiene, and (5) an enhanced risk for tooth decay in psoriasis. Patients with psoriasis (19 female, 31 male) had a median age of 56 years, controls (17 female, 8 male) of 40 years. Individuals were given a questionnaire about general and dental health. Tooth and periodontal status was ascertained (perio-tools®, CA Ramseier, Univ. Berne, Switzerland). The DMFT-index (decayed, missing, filled teeth), BOP (bleeding on probing), PSI-Index (periodontal screening) were measured. Bacterial analyses from gingival pockets were done by micro-IDent ®/Hain Lifescience measuring 5 parodontal species by PCR. IL-1 gene variants were determined from buccal swabs/Hain Lifescience. Statistical analyses, t-test, U-test, Chi-square, Fisher’s exact test were done by SPSS 23 software. We found the following results: Psoriasis patients were smokers in 40% vs. 12% in controls (p<0.03). Interdental tooth cleaning was done in 38% of patients but in 80% of controls (p<0.001). There was no difference in cariogenic nutrition. Regular dentist visits were less frequent in psoriasis (64 vs. 96%). Gingivitis, tooth migration, tooth loss after loosening, gingival treatment did not differ. Missing, decayed or carious teeth were more frequent in psoriasis (10.3 vs. 6.4, p<0.013). DMFT-Index did not differ. Gingival pockets (>3.5 mm) were more frequent in psoriasis (85.4 vs. 60%, p<0.021). BOP did not differ. Bacterial growth occurred in 95.8% in psoriasis vs 72% in controls (p<0.006), specifically of the Tannerella forsythia-species (p<0.05). IL-1 genotype did not differ. Periodontal risk was significantly higher in psoriasis (48% vs. 25%, p<0.029). Our data indicate that periodontitis can be considered as a risk factor for psoriasis.