Oral health-related quality of life depending on oral health in patients with rheumatoid arthritis

Clin Oral Investig. 2017 Dec;21(9):2661-2670. doi: 10.1007/s00784-017-2068-4. Epub 2017 Feb 11.

Abstract

Background: The aim of this study was to evaluate the oral health-related quality of life (OHRQoL) in patients with rheumatoid arthritis (RA) depending on their oral health in comparison with healthy controls (HCs).

Methods: One hundred three RA patients (55.5 years, female 58) were included. A healthy control group (HC n = 104; 56.7 years, female 68) was matched according to age, gender, and smoking habits. The OHRQoL was determined by Oral Health Impact Profile (OHIP)-G14 questionnaire. Oral examination included dental findings (DMF-T), gingival inflammation (PBI), periodontal probing depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP). Based on CAL and/or PPD, periodontitis was categorized as healthy/mild, moderate, or severe.

Statistical analysis: trend test (Cochran-Armitage) and Wilcoxon rank-sum test (α = 5%).

Results: For DMF-T (RA 17.6 ± 6.1, HC 16.0 ± 6.5) and PBI (RA 0.10 ± 0.18, HC 0.08 ± 0.18), no significant differences between both groups were found (p > 0.05). Approximately 65% of RA group and 79% of HC group showed moderate to severe periodontitis (p = 0.02); RA patients showed significantly higher BOP values (p < 0.01). OHRQoL was significantly worse in RA group compared to HC group (mean OHIP value RA = 7.3 ± 7.2, HC = 1.6 ± 2.1; p < 0.001). In the HC group, a significant effect of DMF-T, M-T, and PD on OHRQoL was detected (p < 0.01), whereas in the RA group, no influence was determined (p > 0.05).

Conclusion: RA patients showed a worse OHRQoL than HC patients, which was independent of dental and periodontal conditions. RA patients require a more intensive care in consideration of dental, medical, and psychological factors.

Clinical relevance: Interdisciplinary collaboration between dentists and rheumatologists is necessary, whereby psychological factors should be considered.

Keywords: Oral health; Oral health-related quality of life; Periodontitis; Rheumatoid arthritis.

MeSH terms

  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / psychology*
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Oral Health*
  • Quality of Life*
  • Surveys and Questionnaires