Dental and Oral Manifestations of Rheumatoid Arthritis: Is It Related to General Disease Activity?

Omnia A. Abubakr, Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt
Ali M Youssef, Department of Rheumatology and Immunology, Banha Teaching Hospital, Banha, Egypt
Mohamed A Mohamed, Department of Oral Medicine and Periodontology, Banha Teaching Hospital, Banha, EgyptFollow
Mohamed A Hamdy, Department of Oral Medicine and Periodontology, Banha Teaching Hospital, Banha, Egypt

Article Type

Original Study

Subject Area

Rheumatology and Rehabilitation

Abstract

Background: RA is a chronic immune-mediated systemic disorder; its pathogenesis is complex. Genetic, environmental, hormonal, and lifestyle are the main risk factors. The correlation between oral health and RA is rising. Oral manifestations in RA include temporomandibular joint disorder, secondary Sjögren’s syndrome, xerostomia, and periodontal disease. Previous studies suggest a bidirectional relationship between RA and periodontal diseases. This study aims to detect oral mucosal and dental disease in RA patients and its relation to demographic features, disease activity, and extra-articular manifestation. Patients and Methods: This cross-sectional study included 150 patients with RA allocated into two groups, 75 patients in each group, according to RA disease control with Anti-rheumatic medications: Group A included patients who had controlled RA and receiving Anti-rheumatic medications, and Group B included uncontrolled RA patients not receiving Anti-rheumatic medications. The assessment included DAS28, ESR, CRP, RF, and ACCPA measurements. The oral and dental examination included: probing pocket depth, clinical attachment level, gingival recession height measurement, gingival Index, mobility Index, the Plaque Index System, dry mouth, the DMF index, and bleeding on probing. Result: The dental and oral findings were statistically significantly higher in group B compared to group A, except for gingival recession height. There was a positive correlation between probing pocket depth, clinical attachment level, gingival Index, mobility Index, the Plaque Index System, dry mouth, the DMF index, bleeding on probing and age, extra-articular manifestations, TMJ disorder, DAS28, ESR, CRP, RF and ACCPA levels. No correlation was found between gingival recession height and age, extra-articular manifestations, TMJ disorder, and RF. Conclusion: Our study revealed higher dental and oral manifestations in patients not receiving anti-rheumatic medications. Dental manifestations correlated positively with age, extra-articular manifestations, tempromandibular joint disorder, rheumatoid arthritis disease activity score, acute phase reactant, and autoantibodies levels

IRB Number

HB000119

Keywords

Rheumatoid arthritis, oral, dental, periodontitis

Recommended Citation

Abubakr, Omnia A.; Youssef, Ali M; Mohamed, Mohamed A; and Hamdy, Mohamed A (2023) "Dental and Oral Manifestations of Rheumatoid Arthritis: Is It Related to General Disease Activity?," Journal of Medicine in Scientific Research: Vol. 6: Iss. 2, Article 4.
DOI: https://doi.org/10.59299/2537-0928.1029