Abstract
It has been reported that patients with rheumatoid arthritis (RA) are more likely to exhibit periodontitis than patients without RA. However, the frequency and severity of dental caries in patients with RA is still unknown. The aim of the study was to investigate whether higher counts of cariogenic bacteria are present in RA patients in contrast to healthy subjects, and to ascertain whether the frequency and severity of dental caries are increased in RA patients. The study involved 160 adults: an RA group (n = 80) and a control group matched by age and gender (n = 80). The participants' dental status scores were determined based on the following indices: the Decayed, Missing and Filled Teeth (DMFT) index, the Filled and Sound Teeth (FS-T) index, Treatment Needs Index (TNI), Care Index (CI), and Integrative Dental Caries Index (IDCI). DNA copies of Streptococcus mutans (S. mutans) and Streptococcus sobrinus (S. sobrinus) were quantified using realtime polymerase chain reaction (PCR). The IDCI showed that the RA group was more affected, mainly presenting moderate to severe dental caries. The RA group also had higher global DMFT scores than the control group and scored higher on the decayed component of the DMFT index. The TNI and CI indicated that RA patients required more dental attention and appropriate treatment. The Streptococcus mutans count was significantly higher in the RA group. A complete basic oral examination, along with oral health instruction including adequate oral and dental hygiene, is crucial to prevent dental caries and associated complications in RA patients, since they appear to be more vulnerable than the non-RA population.
Highlights
Rheumatoid arthritis (RA) is a chronic destructive inflammatory disease consisting in joint damage and bone erosion, and leading to functional disability.[1]
A complete basic oral examination, along with oral health instruction including adequate oral and dental hygiene, is crucial to prevent dental caries and associated complications in rheumatoid arthritis (RA) patients, since they appear to be more vulnerable than the non-RA population
It is important to note that the RA group had a higher rate of decayed teeth, but a lower count of filled teeth compared to the control group
Summary
Rheumatoid arthritis (RA) is a chronic destructive inflammatory disease consisting in joint damage and bone erosion, and leading to functional disability.[1]. 1% and is characterized by substantial morbidity and accelerated mortality.[2,3] It is accompanied in many cases by oral manifestations, such as temporomandibular joint disorders, secondary Sjögren’s syndrome and xerostomia.[4,5,6] Xerostomia is related to hyposalivation, which is considered a cariogenic condition, since saliva plays an important role in preventing the development of dental caries. Dental caries is regarded as a preventable non-communicable disease that affects a majority of the population across their lifespan and, along with periodontal disease, is considered the most important oral disease.[8,9] Approximately 300 bacterial species have been found to be associated with dental plaque, but only Streptococcus mutans (S. mutans) and Streptococcus sobrinus (S. sobrinus) have been consistently linked to the etiology of human dental caries.[10] S. mutans and S. sobrinus have been associated with non-oral infections, such as subacute bacterial endocarditis, atherosclerosis, coronary artery disease, and other systemic conditions.[11,12]. The frequency and severity of dental caries in patients with RA is still unknown
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