Association Between Rheumatoid Arthritis and Periodontitis in an Adult Population - A Cross Sectional Study

Background: This investigation was aimed to analyse the existence of an association between rheumatoid arthritis and periodontitis among Indian subjects.

Material And Methods: This observational study included a total of 110 individuals between 18-78 years of age, which were divided equally into RA (Rheumatoid Arthritis) and NRA (Non-Rheumatoid Arthritis) groups. General, Oral and a complete Periodontal examination included recording of Gingival Index (GI), Plaque index (PI), Pocket Probing Depth (PPD), Clinical attachment level (CAL) in a questionnaire form. Laboratory and rheumatologcal parameters like C-reactive protein (CRP), Erythrocyte sedimentation rate (ESR) and Disease Activity Score 28(DAS 28), Health Assessment Questionnaire-Disability Index (HAQ), Rheumatoid factor (RF) were also respectively estimated.

Results: Prevalence of moderate or severe periodontitis was higher in RA than in NRA group. (41.8% vs 23.6%, = 0.047). Periodontal structural damage represented by clinical attachment level was more in RA patients (2.89 mm v/s 2.54mm, =0.261). Mean score of HAQ was co-related significantly in patients with CAL ≥ 2mm than with CAL < 2mm (0.69 v/s 0.455, =0.0415). Through logistic regression analysis, periodontitis and CAL were related to RA with OR (Odds Ratio) of 2.1 and 2.89 respectively.

Conclusions: Indian RA patients have higher odds for periodontitis and CAL may act as a risk indicator for RA. Chronic periodontitis, rheumatoid arthritis, disease activity score 28, health assessment questionnaire, rheumatoid factor, c-reactive protein , erythrocyte sedimentation rate.