RESEARCH - Over half of people with RA also have periodontitis

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ScienceDaily (June 12, 2009) — Over half (56%) of people with

rheumatoid arthritis (RA) also have periodontitis (a chronic

inflammatory disease of the gum and surrounding ligaments and bones

that hold the teeth in place), displaying fewer teeth than healthy

matched controls, high prevalence of oral sites presenting dental

plaque and advanced attachment loss (the extent of periodontal support

that has been destroyed around a tooth) (chi square p<0.05), according

to the results of a new study presented June 12 at EULAR 2009, the

Annual Congress of the European League Against Rheumatism in

Copenhagen, Denmark.

In addition, these patients were found to have significantly higher RA

disease activity and anti-CCP (cyclic citrullinated peptide) antibody

levels than others with RA who did not exhibit periodontitis (r=0.84,

p<0.05; r=0.78, p<0.05).

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 (80%) of the 25 participants (mean age 41.5+3.7 years; mean

disease duration 7.2+4.8 years), suggesting that the biological

therapy may also be able to modulate the inflammatory process in the

periodontium (the tissues investing and supporting the teeth,

including the cementum, periodontal ligament, alveolar bone, and

gingival / gums).

Dr Codrina Ancuta of the Grigore T Popa University of Medicine and

Pharmacy, Rehabilitation Hospital, Iasi, Romania, who led the study,

said: " There is a growing body of evidence to demonstrate an

association between periodontal disease and systemic conditions

involving inflammatory rheumatic disease (especially RA),

cardiovascular disease and diabetes. 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 approached that may simultaneously address both

conditions. "

The prospective observational study compared 25 consecutive RA

patients receiving anti-TNFs with 25 systemically healthy individuals

matched for age, gender and periodontal status at baseline and six

months, assessing both groups for periodontal status (visible plaque

scores, marginal bleeding scores, attachment loss, number of present

teeth), and the RA patient group in terms of RA parameters

(erythrocyte sedimentation rate (ESR), C-reactive protein (CRP),

anti-CCP antibodies, disease activity and disability scores).

Statistical analysis was conducted in SPSS-14 (a statistical analysis

computer programme) p<0.05.

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Read the full article here:

http://www.sciencedaily.com/releases/2009/06/090612115429.htm

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