There are conflicting reports as to whether patients with rheumatoid arthritis (RA) are at high risk for periodontal disease (PD). However, analogous mechanisms of tissue destruction have been reported for the 2 conditions. The present study was undertaken to determine temporomandibular joint (TMJ) problems and periodontal conditions in patients with RA in relation to their rheumatologic status and identify their periodontal needs.
One hundred patients with PD, 50 with RA and 50 without RA, were assigned to 1 of 2 age groups (30 to 39 or 40 to 50 years). The plaque index, bleeding index, clinical attachment loss, radiographic bone loss, tooth loss, and TMJ problems were assessed in the 2 groups. Disease duration, level of erythrocyte sedimentation rate (ESR), Health Assessment Questionnaire, and Verbal Descriptor Pain Scale score were assessed in the RA group.
Patients with RA were predominantly women, with longer illness duration (11.84 years), higher ESR (32.08 mm/hour), and higher scores on the Health Assessment Questionnaire (0.82). Patients with RA were characterized by significant increases in clinical attachment loss (3.24 mm), bone loss (1.79 mm), missing teeth (6.22), and TMJ problems (54%) than controls. Their periodontal status significantly correlated with illness duration, Health Assessment Questionnaire score, and Verbal Descriptor Pain Scale score. However, no difference in plaque index and bleeding index were observed between the RA and control groups. Unexpectedly, 30- to 40-year-old patients with RA had a significantly higher plaque index (1.54) and greater TMJ deviation (15%) than the older subjects.
Patients with advanced RA are more likely to develop more significant periodontal and TMJ problems compared with patients with PD and without RA. There is a great need to instruct patients with RA to consult a dentist to at least decrease PD severity.