According to a study, patients with rheumatoid arthritis (RA) show not only an increased frequency of visits to the dentist, but also an increased frequency of dental diseases.
“There is a very strong and complex relationship between periodontitis and RA,” write the study authors, led by Ching-Ya Huang of Daling Tzu Chi Hospital in Chiayi, Taiwan. “Both periodontitis and RA shared similar pathogenesis, including an imbalance between pro- and anti-inflammatory cytokines, the role of smoking, microbial dysbiosis, especially Porphyromonas gingivalis, and a genetic background.”
Huang and his team assessed the number of dental visits for 1,337 patients with newly diagnosed RA between January 2000 and December 2012. These patients were matched to a subgroup of 13,370 healthy individuals for age and gender.
The prevalence of dental visits among RA patients was higher than in the healthy cohort at 70.3% compared to 66.7%. The frequency of visits was also higher – 2.67 visits per year compared to 1.78.
Patients with RA are also more likely to be diagnosed with dental caries, pulpitis, gingivitis, periodontitis, and oral ulcers. But compared to healthy control groups, temporomandibular joint diseases are not diagnosed. The authors write that the results were especially extended to female patients.
Importantly, patients with a primary diagnosis of Sjögren's syndrome were excluded from this study because Sjögren's syndrome is known to be a strong risk factor for caries. However, the patients in the study may have had secondary Sjögren's syndrome, and hyposalivation could be a common risk factor for both RA and dental disease, the authors noted.
“Both rheumatologists and dentists should regularly evaluate the oral health of patients with RA,” the team concluded.