RESEARCH - Association of periodontal disease and tooth loss with RA in the US population

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J Rheumatol. 2008 Jan;35(1):70-6. Epub 2007 Nov 15.

Association of periodontal disease and tooth loss with rheumatoid

arthritis in the US population.

de Pablo P, Dietrich T, McAlindon TE.

Division of Rheumatology, Department of Medicine, Tufts New England

Medical Center, Tufts University School of Medicine, Boston, MA 02111,

USA.

Abstract

OBJECTIVE: To test for an association of periodontitis and tooth loss

with rheumatoid arthritis (RA).

METHODS: The third National Health and Nutrition Examination Survey

(NHANES III) is a nationally representative cross-sectional survey of

noninstitutionalized civilians. We included participants aged > or =

60 years who had undergone both musculoskeletal and dental

examinations. RA was defined based on American College of Rheumatology

criteria. Dental examinations quantified decayed and filled surfaces,

missing teeth, and periodontitis. Periodontitis was defined as at

least 1 site exhibiting both attachment loss and a probing depth of >

or = 4 mm. We classified dental health status as (1) no periodontitis,

(2) periodontitis, or (3) edentulous (i.e., complete tooth loss). We

performed multivariate multinomial logistic regression models with

dental health status as the dependent and RA as the independent

variables.

RESULTS: The sample consisted of 4461 participants, of whom 103 were

classified as having RA. Participants with RA had more missing teeth

(20 vs 16 teeth; p < 0.001), but less decay (2% vs 4%; p < 0.001) than

participants without RA. After adjusting for age, sex, race/ethnicity,

and smoking, subjects with RA were more likely to be edentulous [odds

ratio (OR) 2.27, 95% confidence interval (CI) 1.56 3.31] and have

periodontitis (OR 1.82, 95% CI 1.04 3.20) compared with non-RA

subjects. In participants with seropositive RA there was a stronger

association with dental health status, in particular with edentulism

(OR 4.5, 95% CI 1.2 17).

CONCLUSION: RA may be associated with tooth loss and periodontitis.

PMID: 18050377

http://www.ncbi.nlm.nih.gov/pubmed/18050377

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