Periodontal Disease and Rheumatoid Arthritis

Abstract

This systematic review considers the evidence available for a relationship between periodontal disease and rheumatoid arthritis. MEDLINE/PubMed, CINAHL, DOSS, Embase, Scopus, Web of Knowledge, MedNar, and ProQuest Theses and Dissertations were searched from the inception of the database until June 2012 for any quantitative studies that examined the association between periodontal disease and rheumatoid arthritis. Nineteen studies met our inclusion criteria. Good evidence was found to support an association between these conditions with regard to tooth loss, clinical attachment levels, and erythrocyte sedimentation rates. Moderate evidence was noted for C-reactive protein and interleukin-1β. Some evidence for a positive outcome of periodontal treatment on the clinical features of rheumatoid arthritis was noted. These results provide moderate evidence based on biochemical markers and stronger evidence with regard to clinical parameters that common risk factors or common pathologic processes may be responsible for an association between rheumatoid arthritis and periodontal disease. Further studies are required to fully explore both the biochemical processes and clinical relationships between these 2 chronic inflammatory conditions. There is a need to move from case-control studies to more rigorous studies using well-defined populations and well-defined biochemical and clinical outcomes as the primary outcome measures with consideration of potential confounding factors.

Prelude to oral microbes and chronic diseases: past, present and future

“…As players in the etiology of periodontal disease, several oral bacteria have been studied for association with RA etiology. Clinical studies have detected P. gingivalis, Prevotella intermedia , and Prevotella nigrescens DNA in sera and synovial fluids of RA patients [56], and antibodies against P. gingivalis, A. actinomycetemcomitans and few other oral microbiota constituents have also been found in sera of patients suffering from RA, compared to healthy controls [53, 54]. …”

Proteome Analysis of Coinfection of Epithelial Cells with Filifactor alocis and Porphyromonas gingivalis Shows Modulation of Pathogen and Host Regulatory Pathways

“…One such inflammatory disease, periodontitis, has a multifactorial etiology which is influenced by host genetics and several environmental factors. Further, there is evidence that this inflammatory disease affecting the periodontium represents an increased risk for several systemic diseases, including atherosclerosis (1), diabetes (2), and rheumatoid arthritis (3,4). Historically, periodontal disease is associated with several pathogens contributing to a complex microbial milieu which can initiate or directly contribute to host tissue destruction (5).…”

Assessment of Pyrexia and Associated Sickness Behavior in Patients with Chronic Periodontitis

“…In this study, ESR was increased in patients who had a higher temperature, and 90% of these were in the group suffering from periodontitis. However, in a systematic review, it was concluded that ESR as a value is an inconclusive parameter, and that results based on it should be interpreted with caution [32]. …”