Study links rheumatoid arthritis and perio disease

Jun 11, 2009

A new study presented Friday at the 2009 European League Against Rheumatism (EULAR) Congress in Copenhagen, Denmark, found that more than half the subjects with rheumatoid arthritis (RA) also had periodontitis.

The prospective observational study compared 25 RA patients receiving drugs that blocked the production of tumor necrosis factor (TNF) with 25 systemically healthy individuals.

Subjects with both conditions had fewer teeth than healthy matched controls, a high prevalence of oral sites with dental plaque, and advanced attachment loss, according to the study results.

In addition, these patients were found to have significantly higher RA disease activity and anticyclic citrullinated peptide (CCP) antibody levels than others with RA who did not have periodontitis.

The study also showed that, after six months of anti-TNF therapy -- prescribed to control RA inflammation and destruction -- a statistically significant improvement in periodontal status was seen in 20 participants, suggesting that the biological therapy may also be able to modulate the inflammatory process in the periodontium.

"There is growing body of evidence to demonstrate an association between periodontal disease and systemic conditions involving inflammatory rheumatic disease (especially RA), cardiovascular disease, and diabetes," said study author Dr. Codrina Ancuta of the Grigore T. Popa University of Medicine and Pharmacy, Rehabilitation Hospital in Iasi, Romania. "However, further cross-disciplinary research among rheumatologists and periodontologists is required to fully understand the underlying mechanisms that link RA and periodontitis, and to explore how patients can be managed more holistically using treatments such as anti-TNFs and some lifestyle approach that may simultaneously address both conditions."