The Effect of Periodontal Treatment on Clinical and Biological Indicators, Quality of Life, and Oral Health in Rheumatoid Arthritis Patients: A Quasi-Experimental Study

Abstract

Non-surgical periodontal therapy (NSPT) has been shown to have systemic effects. It has been suggested that, similar to rheumatoid arthritis (RA), periodontitis (PD) has an impact on general health, in terms of psychological, physical, and social aspects. This study determines the effect of periodontal treatment in RA activity, health-related quality of life, and oral health self-perception before and after periodontal treatment in RA patients. A quasi-experimental, prospective, non-randomized study was conducted, and 52 patients were included in the study. Periodontal parameters and the instruments disease activity score-28 (DAS-28), SF-36, and OHIP-14 were measured at baseline and at 3 months after NSPT. All differences were statistically assessed. The study protocol was registered in Clinical Trials (NCT04658615). No statistically significant differences were found in the scores of DAS-28 before and after the intervention in the group with PD and reduced periodontium. When the effect of periodontal treatment was analyzed in the group of 29 patients who were followed up, it was found that there were statistically significant differences before and after in variables such as psychological distress, emotional role, and mental health, which indicates an improvement in the scores of these variables. NSPT influenced the health-related quality of life measured with SF-36 and OHIP-14 in patients with RA. In conclusion, NSPT has an effect on self-reported quality of life and health indicators more than the RA activity as measured with DAS-28. However, the clinical effect of periodontal treatment in RA patients provides important data to support periodontal care in patients.

The Influence of Periodontal Disease on Oral Health Quality of Life in Patients with Cardiovascular Disease: A Cross-Sectional Observational Single-Center Study

“…It reflects changes at the physiological, psychological and social levels, and it also gives an insight into a person’s overall health status [ 52 , 53 ]. An adequate treatment performed brings a significant improvement in individuals [ 54 , 55 ].…”

The Effects of Periodontal Treatment on Rheumatoid Arthritis and of Anti-Rheumatic Drugs on Periodontitis: A Systematic Review

“…Similar results derive from the clinical study of Posada-Lòpez A: NSPT has a positive effect on only quality of life and self-reported health indicators (Oral Health Impact Profile-14 and Short Form Health Survey 36), ameliorating psychological distress, emotional role, and mental health. No significant changes are reported in DAS28 [108].…”

NF-κB in biology and targeted therapy: new insights and translational implications

“…Periodontitis is characterized by the pathological loss of periodontal ligament and alveolar bone. 365 The disease involves complex interactions between specific bacterial pathogens and destructive immune responses. 365 , 366 In a model of periodontitis, a single intra-gingival injection of LPS results in the significant expression of NF-κB p65 and pro-inflammatory cytokines in gingival tissues after 14 h. This is accompanied by increased expression of COX-2 and iNOS, as well as elevated levels of cytokines TNF-α and IL-1β.…”

“… 365 The disease involves complex interactions between specific bacterial pathogens and destructive immune responses. 365 , 366 In a model of periodontitis, a single intra-gingival injection of LPS results in the significant expression of NF-κB p65 and pro-inflammatory cytokines in gingival tissues after 14 h. This is accompanied by increased expression of COX-2 and iNOS, as well as elevated levels of cytokines TNF-α and IL-1β. These changes are often associated with heightened nociceptive perception, supporting the involvement of NF-κB in the pathogenesis of periodontitis.…”