More arthritis, more periodontitis?

PD Dr. Kristina Bertl, PhD MSc MBA

Rheumatoid arthritis ist eine chronic inflammatory autoimmune condition, which primarily affects the peripheral joints. Rheumatoid arthritis affects around 0.4 to 0.9% of the European population and is more common in women. Without appropriate treatment, the cartilage and bone tissue in the affected joints is destroyed. However, new treatment methods and medications have considerably improved the prognosis for patients.

More arthritis, more periodontitis?

Rheumatoid arthritis may result in restricted mobility and in reduced dexterity of the fingers, which in turn may impair the ability to maintain oral hygiene. However, other than this purely mechanical restriction, there seems to be a link between periodontitis and rheumatoid arthritis. Links have been described between the two conditions based on shared risk factors (e.g. smoking), genetic risk factors, similarities in the inflammation and negative influences from periodontopathogenic bacteria. A recently published study from Norway highlighted another very interesting aspect (Bolstad et al., 2023). This study aimed to investigate whether patients with rheumatoid arthritis are at increased risk of periodontitis and whether this risk is influenced by the disease activity of the rheumatoid arthritis.

Based on the Norwegian patient registry, over 320,000 patients were included in this study, of whom more than 33,000 had been diagnosed with rheumatoid arthritis; in addition, more than 52,000 patients had periodontitis. During the evaluation, consideration was also given to how often the patients with rheumatoid arthritis had received treatment due to rheumatoid arthritis within seven years. The results produced the following findings:

What conclusions does this study allow us to make for dental practice? On the one hand, it provides interesting information for GPs, and it is important to tell patients with rheumatoid arthritis about the possible link and to send them to the dentist for a check-up. On the other hand, we are also responsible for explaining things to affected patients, giving them the best possible support from a dental perspective and preventing the occurrence of periodontal diseases.

Reference

1. Bolstad, A. I., Fevang, B.-T., & Lie, S. A. (2023). Increased risk of periodontitis in patients with rheumatoid arthritis: A nationwide register study in Norway. Journal of Clinical Periodontology, 50(8), 1022–1032. https:// doi.org/10.1111/jcpe.13826