Tooth Loss Is Associated with Disease-Related Parameters in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis-A Cross-Sectional Study

Background: The aim of this cross-sectional study was to investigate potential associations between periodontal inflamed surface area (PISA) and tooth loss with disease-related parameters in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS).

Methods: Patients who attended the Department of Nephrology and Rheumatology, University Medical Centre Goettingen, Germany, were included. The oral examination comprised the detection of the number of remaining teeth and periodontal condition based on staging and grading matrix. Based on periodontal pockets with positive bleeding on probing, the periodontal inflamed surface area (PISA) was determined. Disease related parameters were extracted from the patients' records.

Results: In total, 101 (RA) and 32 participants (AS) were included. Patients with RA had 22.85 ± 4.26 and AS patients 24.34 ± 5.47 remaining teeth ( < 0.01). Periodontitis stage III and IV was present in 91% (RA) and 81.2% (AS) of patients ( = 0.04). Associations between PISA and disease-related parameters were not found in both groups ( > 0.05). In RA, a higher age ( < 0.01), C-reactive protein ( = 0.02), disease activity ( < 0.01) and prednisolone intake ( < 0.01) were associated with fewer remaining teeth. In AS, a higher age ( = 0.02) and increased Bath Ankylosing Spondylitis Metrology Index ( = 0.02) were associated with a lower number of remaining teeth.

Conclusions: Tooth loss is associated with disease activity, especially in RA individuals. Dental care to prevent tooth loss might be recommendable to positively influence oral health condition and disease activity in RA and SA patients.