Association between periodontal disease temporomandibular disorders and rheumatoid arthritis among patients visiting rheumatology centers in Bengaluru City: A cross-sectional study

Abstract

Introduction: Association between rheumatoid arthritis (RA), periodontitis and temporomandibular disorder (TMD) can be an outcome of the existing inflammatory conditions or involvement of joints at a different level of severity. Aim: This study aims to find an association between periodontal disease and TMDs and RA among patients visiting various Rheumatology centers in Bengaluru city. Materials and Methods: A total of 100 RA patients and age- and gender-matched comparison group were recruited from various Rheumatology centers in Bengaluru city. Periodontal status and loss of attachment (LOA) were measured from the World Health Organization (2013) criteria and TMDs and severity were assessed using Helkimo index (1987). Data were analyzed and comparisons were done using Chi-square test and independent t-test (P < 0.05). Correlation and association are measured through spearman's correlation and logistic regression analysis. Results: There was a significant difference regarding shallow and deep periodontal pocket depth among RA (4.62 ± 2.33, 1.48 ± 1.7) and comparison (3.48 ± 2.53, 0.83 ± 1.05) groups (P = 0.01). Impaired mobility (P = 0.012), altered function (P = 0.032), painful function (P = 0.023), muscle pain (P = 0.028), and temporomandibular joint pain (P = 0.048) differed significantly between RA group and comparison group. RA patients were more likely to suffer from TMD (OR = 4.88) and LOA (OR = 2.16) than the comparison group. Conclusion: Periodontitis and TMD are found to be associated with RA. A dental check-up for patients suffering from RA should be part of the routine RA assessment.