RISK FOR PERIODONTAL-DISEASE IN PATIENTS WITH LONGSTANDING RHEUMATOID-ARTHRITIS

Objective. To quantify periodontal disease in rheumatoid arthritis (RA ) patients and controls, and to correlate the degree of destruction fr om periodontal disease and from RA. Methods. Fifty RA patients were ma tched for age, sex, smoking status, and oral hygiene with 101 controls , Correlations between indices of chronic destruction in periodontal d isease (gingival attachment loss) and in RA (Larsen radiographic score ) were determined. Results. Patients with longstanding active RA (mean +/- SD 13 +/- 8 years) who were receiving treatment with disease-modi fying antirheumatic drugs (n = 46), corticosteroids (n = 38), or nonst eroidal antiinflammatory drugs (n = 43) had a higher rate of gingival bleeding (increased by 50%), greater probing depth (increased by 26%), greater attachment loss (increased by 173%), and higher number of mis sing teeth (increased by 29%) compared with controls, No correlation w as found between the Larsen radiographic score and gingival attachment . Conclusion. Patients with longstanding active RA have a substantiall y increased frequency of periodontal disease, including loss of teeth, compared with controls, Antiinflammatory treatment interferes with pe riodontal disease and might have masked a possible correlation between the indices of chronic destruction in RA and periodontal disease.