Rheumatoid arthritis and periodontitis: a Jordanian case-control study

Abstract

Rheumatoid arthritis (RA) patients may have a higher risk to develop periodontitis (PD) than healthy controls, but the results are inconsistent. The aim of this study was to assess the prevalence and severity of periodontal disease among Jordanian patients with RA in comparison with RA free control group. A case control study from Jordan included 202 subjects, 102 with RA and 100 without RA (controls). Patients were enrolled from rheumatology clinic and emergency clinic at King Abdullah University Hospital in Jordan during a 6-month period. The plaque index (PI), gingival index (GI), probing pocket depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) were performed. In addition, the number of decayed, missing, and filled teeth (DMFT) was measured. A questionnaire focusing on potential risk factors for periodontal disease such as smoking, education, alcohol consumption, and body mass index (BMI), as well as chronic diseases associated with RA and periodontal disease was assessed. Findings of RA patients and control group were analyzed using one-way ANOVA, post hoc tests, logistic regression analysis and chi-squared tests. About 63.7% of RA patients and 30.0% of non-RA group had PD (p < 0.005). In multivariate analysis, after adjustment of age, gender and number of missing teeth, subjects with RA (OR = 7.14, 95% CI: 3.38, 15.15) were found to have a significantly higher odds of PD compared to control group. The severity and extent of periodontal disease were found to be significantly higher in RA patients compared to controls (P < 0.05) when measured by percentage of sites with PPD ≥ 3 mm, PPD ≥ 4 mm, CAL ≥ 3, CAL ≥ 4, and bleeding on probing. In addition, DMFT was higher in subjects with RA as compared to non-RA (p = 0.048). RA subjects had increased prevalence of having periodontitis compared to controls. Therefore, interventions to prevent, minimize or treat periodontitis may improve the health status of RA patients.