Rheumatoid Arthritis Patients Also Suffer from Poor Oral Health

Phillip Bonner, DDS


A prospective cohort study published in Rheumatology International investigated oral health in patients with rheumatoid arthritis (RA), with emphasis on disease activity and treatment of RA. The study involved 81 RA patients: 53 early untreated RA (EURA) and 28 chronic RA (CRA) patients with inadequate response to synthetic disease modifying antirheumatic drugs (DMARDs).

The patients underwent rheumatological (Disease Activity Score [28-joint] DAS28) and dental examinations (total dental index [TDI], decayed missing filled teeth [DMFT] and decayed missing filled surfaces [DMFS]). For controls, 43 volunteers were examined.

After the examinations, EURA patients started treatment with synthetic DMARDs, oral and intra-articular glucocorticoids. CRA patients were candidates for biological DMARDs. The patients were re-examined mean 16 months later, and the results were analyzed.

The study found that TDI was higher in both RA groups at baseline compared to controls. DMFT and DMFS were associated with DAS28 at baseline in CRA patients. After follow-up, DAS28 associated positively with DMFT and DMFS in EURA patients as well as in CRA patients. 

The study concluded that RA patients already in the early phase of the disease had poorer oral health compared to controls. The caries indices were associated with the activity of RA in both patient groups. Oral status may thus contribute to the development and further relate to the activity of RA. (Source: Rheumatology International, September 2018, Vol. 38, Issue 9.)

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