Objectives: To evaluate oral hygiene status in Rheumatoid arthritis (RA) patients, to analyse possible related factors, and to investigate the role of the rheumatologist in information about importance of adequate oral hygiene status in RA patients. Methods: A cross-sectional study that included 100 consecutive RA patients (89% female, mean age 46.7 ± 11.7 years). For each patient, we recorded oral symptoms, oral hygiene status and role of rheumatologist in information on the oral hygiene status. Factors associated with regular brushing (≥2/day) were also analysed. Results: Median disease duration was 8 years (4;2). Dental pain was reported by 74% of patients and bleeding by 51% of them. Regular brushing was noted in 45% of patients. The use of a correct brushing method was noted in 14% of cases. Two patients reported visiting a dentist regularly. Information explaining that poor oral hygiene has a negative impact on RA was delivered by rheumatologist to 11 patients. Regular brushing of teeth was recommended by rheumatologist to 8 patients and 10 patients were advised by their rheumatologist to consult a dentist. Regular brushing was more important in women (48,3% vs 18,2%; p=0.05) and in the literate patients (57,6 vs 31,2%, p<0.01). No association was found between regular brushing, Disease Activity Score 28 (DAS28) and health Assessment Questionnaire (HAQ). Conclusion: This study illustrates bad oral hygiene status in RA patients, which seems more important in men and illiterate patients. It also highlights poor information given by the rheumatologist.
Background:Methotrexate is a gold standard for treatment of RA. In our context, RA patients prefer to be injected by paramedics rather than self-injecting. This can be explained by patients’ bad perceptions of self-injection or lack of information. Appropriate self-injection education can therefore be an important element in overcoming these obstacles and improving disease self-management.Objectives:Compare the RA patients’ perceptions on methotrexate self-injection before and after a patient education session.Methods:Prospective pilot study that included 27 consecutive patients (81.5% female, mean age 44.4 years, illiteracy rate 40.7%) with RA (median duration of progression of 4 years, mean delay in referral for specialist of 6 months, median duration of methotrexate use of 1 year). The patients benefited from an individual patient education session to learn how to self-inject with methotrexate subcutaneously. The patient education session was supervised by a nurse and a rheumatologist with a control a week later. Perceptions of the reluctance to self-inject and the difficulties encountered by patients were assessed before the patient education session, after the 1st and 2nd self-injection of methotrexate using a 10 mm visual analog scale. Patients also reported their level of satisfaction (10 mm VAS) after the 1st and 2nd self-injection.Results:The mean duration of patient education session is 13 min.Table I compares the evolution of the degrees of reluctance to self-injection, the difficulties encountered, and the satisfaction experienced by the patients.Table 1.Evolution of RA patients’ perceptions on the methotrexate self-injection. (N = 27)BeforeAfter the 1stself-injectionAfter the 2end self-injectionpVAS reluctance (0-10mm)6,5 ± 3,62,2 ± 2,91,0 ± 2,3<0,0001VAS difficulty (0-10mm)7,5 ± 2,62,5 ± 2,71,0 ± 1,9<0,0001VAS satisfaction (0-10mm)-8,9 ± 1,89,5 ± 1,50,002Conclusion:This study suggests the effectiveness of a methotrexate self-injection patient education session in RA patients. It also highlights the value of patient education in rheumatologic care. A large-scale study is necessary to better interpret and complete these preliminary results from this pilot study.Disclosure of Interests:None declared
Background:The relationship between oral hygiene and rheumatoid arthritis has been demonstrated by several studies.Objectives:To evaluate oral hygiene status in rheumatoid arthritis (RA) patients.To inform about the therapeutic education given by the rheumatologist on the importance of adequate oral hygiene in the management of RAMethods:This is a cross-sectional study that included 100 consecutive RA patients (89% female, mean age 46.7 years, median disease duration of 8 years, mean specialized care duration of 3 years). A questionnaire evaluating oral hygiene status was administered. It focused on following items: the daily frequency of brushing, the modalities of brushing, the use of other means of oral hygiene, the regular follow-up at a dentist’s doctor and the place of the rheumatologist in therapeutic education on the oral dental hygiene status.Results: Table I illustrates the results of oral hygiene evaluation in RA patients. Table I : Evaluation of Oral Hygiene in RA patients Items N=100 Daily Brushing Frequency (%):- 0 times/day- once a day- 2 times/day- 3 times/day- After each meal18373483adequate brushing time (≥3min) (%) 31Correct brushing method (%) 14Use of other means of oral hygiene (%) 36Regular dentist visit (%) 2Never visit a dentist (%) 27 Table II illustrates the results of the place of oral hygiene information in rheumatologic management. Table II : Place of information on oral hygiene in rheumatologic care. Questions Yes (%) 1. does your rheumatologist ever examined your oral cavity?2. have you ever been informed by your rheumatologist that poor oral hygiene has a negative impact on your rheumatoid arthritis?6,011,03. Does your rheumatologist ever recommended regular brushing of your teeth?8,04. Does your rheumatologist already recommended to you to consult a dentist?10,0Conclusion:This study illustrates the high prevalence of oral hygiene insufficiency in patients followed for RA. It also highlights poor therapeutic education given by the rheumatologist on the importance of adequate oral hygiene in the management of RA.Disclosure of Interests:None declared
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