RESEARCH - Oral and salivary parameters in patients with rheumatic diseases

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Acta Odontol Scand. 2005 Oct;63(5):284-93.

Oral and salivary parameters in patients with rheumatic diseases.

Department of Oral and Maxillofacial Diseases, Helsinki University Central

Hospital, Finland. miia.helenius@...

We studied the presence of secondary Sjogren's syndrome (SS) and the

composition of saliva, prevalence of oral pathogens, periodontitis, mouth

mucosa, and teeth in patients with various rheumatic diseases and in healthy

controls. The hypothesis was that different rheumatic diseases might cause

differences in oral health characteristics because of the liability of

secondary SS in the patients. The study involved 77 patients and 77

age-matched and sex-matched controls. Twenty patients were suffering from

spondylarthropathy (SPA), 18 from ankylosing spondylitis (AS), 24 from

rheumatoid arthritis (RA), and 15 from mixed connective tissue disease

(MCTD). Clinical and radiographic oral health status was recorded and

salivary flow rates were measured. Selected salivary proteins and

immunoglobulins were analysed by routine methods. Minor salivary gland

biopsy samples were taken from the patients for assessment of inflammatory

focus scores. Differences between patients and controls and in between the

different rheumatic diseases were analysed statistically. Secondary SS was

diagnosed in 39% (30/77) of the patients. A severe periodontal condition

(community periodontal index of treatment needs score 3 or 4) occurred in

58% (45/77) of the rheumatic patients compared with only 26% (20/77) of the

controls (p < 0.0001). The severity of focal sialadenitis (focus score)

correlated significant with salivary IgA, IgG, and IgM concentrations.

Salivary albumin, total protein, IgG, and IgM concentrations were higher in

all patient groups than in the controls. The number of patients with low

salivary flow rates was higher in all patient groups compared to controls.

Oral yeast counts were significantly higher in the patients than in the

controls (p < 0.001). In a subgroup analysis, patients with SS had higher

values for salivary IgA and IgM than patients without SS. Dental caries and

oral lactobacilli were more frequent in patients with SS, but SS was not

associated with periodontitis. No major differences were noted in other

salivary biochemical parameters between these two groups. Patients with

rheumatic diseases, irrespective of specific diagnosis, thus had various

alterations in salivary flow and composition and oral health. The findings

may reflect the autoimmune inflammation of the salivary glands frequently

observed in these patients.

PMID: 16419434

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=16419434

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