Abstract
The aim of this study was to assess the prevalence of periodontal disease and the effect of periodontal treatment in patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA). Forty-four RA patients, thirty SpA patients and thirty-nine healthy volunteers were recruited to the study. Periodontal examination included the approximal plaque index (API), bleeding on probing (BoP), probing depth (PD) and number of teeth. Samples from the deepest periodontal pockets were taken for the detection of Porphyromonas gingivalis DNA with the use of the polymerase chain reaction. All subjects with periodontitis, who completed the study, received periodontal treatment consisting of scaling/root planing and oral hygiene instructions. Disease activity scores, clinical and laboratory parameters were assessed before and 4–6 weeks after periodontal treatment. No significant difference in the prevalence of periodontal disease and the presence of P. gingivalis DNA were found in RA and SpA patients compared to healthy controls. Significantly higher API (80% vs 63%; p = 0.01) and a lower number of teeth (20 vs 25, p = 0.001) were found in RA patients. BoP was significantly elevated in SpA patients (51% vs 33%, p = 0.02). Disease activity measured by the DAS28(CRP) was significantly reduced in RA patients after periodontal treatment (p = 0.002). Clinical and biochemical parameters were not improved in SpA patients. Nonsurgical periodontal treatment had an impact on the decrease in RA activity. Periodontal examination is necessary in patients with RA to detect and treat periodontitis at an early stage.
Highlights
Periodontal disease is highly prevalent in the global population
Some researchers have demonstrated that periodontal disease was more prevalent in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA) and psoriasis [13, 14]. Considering these reports suggesting an association between rheumatic diseases, in particular rheumatoid arthritis (RA), and periodontal disease, we investigated the prevalence of periodontal disease and the presence of P. gingivalis DNA in the samples from periodontal pockets in Polish patients with RA and SpA
Mayer et al demonstrated that anti-tumor necrosis factor (TNF)-α therapy resulted in a significant reduction in periodontal inflammation determined by bleeding on probing (BoP) and probing depth (PD) [23]
Summary
Periodontal disease is highly prevalent in the global population. Periodontal disease, initiated by oral bacteria accumulated in dental plaque, is characterized by destructive inflammation of teeth-supporting tissues. The inflammatory process is local, it has been shown that periodontitis can influence systemic health. Various studies demonstrated that periodontal disease was associated with cardiovascular disease, diabetes and adverse pregnancy outcomes [2, 3]. The inflammatory process typically affects small joints of hands and feet. If untreated, it may result in structural damage of the joints involved and lead to the loss of their function and the patient’s significant disability. Recent studies have shown that periodontal disease could be linked to rheumatic diseases, in particular to RA [4, 5].
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