Relationship between rheumatoid arthritis and periodontal disease in Korean adults: Data from the Sixth Korea National Health and Nutrition Examination Survey, 2013 to 2015

Abstract

Background This study aims to investigate the relationship between rheumatoid arthritis and periodontal disease using data from the Sixth Korea National Health and Nutrition Examination Survey (KNHANES, 2013 to 2015). Methods Of 22,948 KNHANES participants, 14,264 who were aged ≥19 years and responded to questions pertaining to periodontal disease and rheumatoid arthritis were analyzed. Periodontal status was measured using the Community Periodontal Index. The authors used a complex sampling analysis by applying an individual sampling weighting to maintain the rolling survey sampling method. To determine the prevalence of rheumatoid arthritis and periodontal disease, a Chi‐squared test was performed. Logistic regression analysis was performed after controlling for selected variables to determine relevance. Results The prevalence of rheumatoid arthritis in patients with periodontal disease was 1.6%, which was higher than in individuals without periodontal disease (1.5%). The prevalence of periodontal disease in individuals with rheumatoid arthritis was 28.4%, which was higher than in subjects without rheumatoid arthritis (27.9%). The risk for periodontal disease was 1.64 times higher in individuals with rheumatoid arthritis than in those without rheumatoid arthritis. Regardless of age or sex, the risk for periodontal disease was 1.97 times higher in the presence of rheumatoid arthritis. However, other logistic regression analysis models, when adjusted for socioeconomic‐, health‐, and oral health‐related factors, did not yield statistically significant findings. Conclusions The study results suggest a possible relationship between rheumatoid arthritis and periodontal disease. Further large cohort studies investigating causal relationships between rheumatoid arthritis and periodontal disease are needed.

Rheumatoid arthritis and periodontitis in adults: Using the Korean National Health Insurance Service‒National Sample Cohort

“…22 Cross-sectional analysis performed in this study indicated that the prevalence of periodontitis in RA patients (19.6%) was higher than in the participants without RA (16.6%) ( Table 1), and the prevalence of RA in periodontitis patients (6.2%) was higher than in the individuals without periodontitis (5.2%) ( Table 2). These findings are in agreement with our previous study 19 where the prevalence of periodontitis in RA patients (28.4%) was higher than that in participants without RA (27.9%).…”

“…The prevalence of RA in this study was determined to be 5.3% (Table 1), which was higher than that in our previous study (1.5%). 19 Although there is a difference in the data collection period between the two studies, the ages of participants in both studies are identical (adults aged ≥19 years). However, in this study, the proportion of younger participants (19 to 30 years) was smaller because a routine health checkup was an inclusion criterion; typically, younger participants have a tendency of not undergoing regular health check-ups.…”

“…Therefore, the mean age of our current study population was higher than that of the previous study and, consequently, the prevalence of RA is expected to be higher. Furthermore, in the previous study, 19 the RA status was obtained from a questionnaire completed by the patient. Consequently, the prevalence of RA may have been lower than the actual value due to recall bias.…”

“…In addition, the prevalence of periodontitis determined in this study was 16.8% (Table 2), <27.9% in the previous study. 19 This difference is probably due to the difference in the definition of periodontitis between the two studies. In this study, both the ICD codes and the treatment codes were used in the definition, and only the individuals who were diagnosed with and treated for periodontitis were defined as periodontitis patients.…”

“…In our previous study, we used data from the sixth Korea National Health and Nutrition Examination Survey (KNHANES, 2013 to 2015) to assess the association between RA and periodontitis, and confirmed potential associations between the two diseases. 19 Nevertheless, the cases of RA in the KNHANES survey were not diagnosed by a medical doctor but rather, the RA status was obtained from a questionnaire completed by the patient, so it was difficult to correctly identify presence of the disease. Therefore, we have used the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database, in which clinical cases are diagnosed by specialists, and aimed to investigate the prevalence and associated factors of RA among individuals with and without periodontitis.…”