Relationship between rheumatoid arthritis and periodontitis

Background: Because of several similar features in the pathobiology of peri odontitis and rheumatoid arthritis, in a previous study we proposed a possi ble relationship between the two diseases. Therefore, the aims of this stud y were to study a population of rheumatoid arthritis patients and determine the extent of their periodontal disease and correlate this with various in dicators of rheumatoid arthritis. Methods: Sixty-five consecutive patients attending a rheumatology clinic we re examined for their levels of periodontitis and rheumatoid arthritis. A c ontrol group consisted of age- and gender-matched individuals without rheum atoid arthritis. Specific measures for periodontitis included probing depth s, attachment loss, bleeding scores, plague scores, and radiographic bone l oss scores. Measures of rheumatoid arthritis included tender joint analysis , swollen joint analysis, pain index, physician's global assessment on a vi sual analogue scale, health assessment questionnaire, levels of C-reactive protein, and erythrocyte sedimentation rate. The relationship between perio dontal bone loss and rheumatological findings as well as the relationship b etween bone loss in the rheumatoid arthritis and control groups were analyz ed. Results: No differences were noted for the plaque and bleeding indices betw een the control and rheumatoid arthritis groups. The rheumatoid arthritis g roup did, however, have more missing teeth than the control group and a hig her percentage of these subjects had deeper pocketing. When the percentage of bone loss was compared with various indicators of rheumatoid arthritis d isease activity, it was found that swollen joints, health assessment questi onnaire scores, levels of C-reactive protein, and erythrocyte sedimentation rate were the principal parameters which could be associated with periodon tal bone loss. Conclusions: The results of this study provide further evidence of a signif icant association between periodontitis and rheumatoid arthritis. This asso ciation may be a reflection of a common underlying disregulation of the inf lammatory response in these individuals.