Relationship between Tooth Loss and the Medications Used for the Treatment of Rheumatoid Arthritis in Japanese Patients with Rheumatoid Arthritis: A Cross-Sectional Study.

Yoshihiro Shimazaki,Hiroko Hashimoto,Shimpei Hashimoto

doi:10.3390/jcm10040876

Yoshihiro Shimazaki, Hiroko Hashimoto + Show 1 more

Open Access

https://doi.org/10.3390/jcm10040876

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Abstract

Background: There is limited information regarding the association between tooth loss and the medications used for the treatment of rheumatoid arthritis (RA). Here, we examined the association between tooth loss, disease severity, and drug treatment regimens in RA patients. Method: This study recruited 94 Japanese patients with RA. The severity of RA was assessed using the Steinbrocker classification of class and stage. Data on RA medications were obtained from medical records. We examined the associations between tooth loss, RA severity, and drug treatment regi mens using multinomial logistic regression analyses. Results: Patients with 1–19 teeth had significantly higher odds ratios (ORs) of taking methotrexate (MTX) (OR, 8.74; 95% confidence interval (CI), 1.11–68.8) and biologic disease-modifying antirheumatic drugs (bDMARDs) (OR, 21.0; 95% CI, 1.3–339.1) compared to those with 27–28 teeth when adjusted for RA severity (class). Furthermore, patients with 1–19 teeth had significantly higher ORs of taking MTX (OR, 9.71; 95% CI, 1.22–77.1) and bDMARDs (OR, 50.2; 95% CI, 2.55–990.6) compared to those with 27–28 teeth when adjusted for RA severity (stage). Conclusion: RA patients with fewer teeth were more likely to take stronger RA therapies, independent of RA severity and other factors.

Highlights

Rheumatoid arthritis (RA) is an inflammatory disease characterized by lesions of the joint synovium
Our observation that RA patients with fewer teeth were more likely to have been treated with biologic disease-modifying antirheumatic drugs (bDMARDs) independent of RA severity suggests that tooth loss is a negative predictor of RA symptom relief
Many patients with significant tooth loss were taking bDMARDs, the results of this study suggest that the medication did not inhibit the underlying alveolar bone resorption that leads to tooth loss

Summary

Introduction

Rheumatoid arthritis (RA) is an inflammatory disease characterized by lesions of the joint synovium. RA affects 0.5–1.0% of the population in Japan. With a male/female ratio of 1/4, new cases are most commonly diagnosed in females aged 30–60. The progression of RA is characterized by destruction of the affected bone and articular cartilage, along with deformity and dislocation of the joints, resulting in chronic dysfunction due to the progression of joint damage. It has been suggested that juvenile idiopathic arthritis could affect the temporomandibular joint of patients [1,2,3]. The primary goals of RA treatment are focused on improving the patient’s physical and mental well-being via pain reduction, prevention of joint destruction, and maintenance of function

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