Rheumatoid Arthritis Risk Associated with Periodontitis Exposure: A Nationwide, Population-Based Cohort Study

Abstract

BackgroundThe risk of periodontitis (PD) is increased in the patient group of rheumatoid arthritis (RA). RA and PD also shared some pathological mechanism. The aim of this study is to investigate the risk of RA associated with PD exposure.Methods and FindingsThis study identified 3 mutually exclusive cohorts using the 1999–2010 Taiwanese National Health Insurance Research Database (NHIRD) to investigate the association between PD and the risk of incident RA. All patients with PD in 2000 were identified from the database of all enrollees as the PD cohort. From the representative database of 1,000,000 enrollees randomly selected in 2010 (LHID2010), individuals without any periodontal disease (PO) during 1999–2010 were selected as the non-PO cohort. Individuals who were not included in the non-PO cohort and received dental scaling (DS) no more than two times per year during 1999–2010 were selected as the DS cohort from LHID2010. Using cox proportional regression analysis, hazard ratios (HRs) with 95% confidence intervals (Cis) were calculated to quantify the association between PD exposure and RA development. In the three-group comparison using the non-PO cohort as reference, we found that the risk of RA was higher in the PD and DS cohorts (HRs, 1.89 and 1.43; 95% CIs, 1.56–2.29 and 1.09–1.87, respectively). For comparisons between two cohorts, the PD cohort had a higher risk of RA than the non-PO and DS cohorts (HRs, 1.91 and 1.35; 95% CIs, 1.57–2.30 and 1.09–1.67, respectively).ConclusionPD was associated with an increased risk of RA development.

Risk of subsequent attention‐deficit/hyperactivity disorder among children and adolescents with amalgam restorations: A nationwide longitudinal study

“…There is no significant difference in age or sex between the LHID2005 and all enrollees in the country's health insurance programme. The LHID2005 has been adopted in many longitudinal epidemiological studies on dental and systemic diseases . Diseases that are in the database are coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM).…”

“…The LHID2005 has been adopted in many longitudinal epidemiological studies on dental and systemic diseases. 15,16 Diseases that are in the database are coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM).…”

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

“…It is an inflammatory disease of the periodontal tissues caused by various pathogens including Porphyromonas gingivalis, Tannerella forsythia , and Treponema denticola . Periodontal disease has also been identified as a potential risk factor for a variety of systemic diseases including cardiovascular disease, diabetes, hypertension, respiratory disease, osteoporosis, metabolic syndrome, and rheumatoid arthritis . As the relationship between periodontal and systemic disease has been revealed, there is continuing interest in the association between general health and oral health, especially periodontal disease, which is increasing in prevalence in Korea…”

“…Periodontal disease has also been identified as a potential risk factor for a variety of systemic diseases including cardiovascular disease, diabetes, hypertension, respiratory disease, osteoporosis, metabolic syndrome, and rheumatoid arthritis. 2,3 As the relationship between periodontal and systemic disease has been revealed, there is continuing interest in the association between general health and oral health, especially periodontal disease, which is increasing in prevalence in Korea. 4 Rheumatoid arthritis is a chronic inflammatory autoimmune disease with a high incidence rate.…”

Scaling experience and related factors in people diagnosed with rheumatoid arthritis

“…최 근에는 류마티스 관절염의 원인이 치주질환을 일으키는 세균과 관련이 크다는 연구결과들이 나오고 있다 [4,[7][8][9][10][11][12]. 국민건강보험공단 코호트 자료를 이용하여 조사한 결과 치주질환이 있는 대상자에서 류마티스 관절염의 발생 가능성이 1.17배 더 높게 나타났으며 [7], 신 등 [8] …”