Oral health status of psoriatic patients managed with modern biological therapy

Maria Olejnik; Kinga Adamska; Zygmunt Adamski; Barbara Dorocka-Bobkowska

doi:10.5114/ada.2021.112317

Oral health status of psoriatic patients managed with modern biological therapy

Postepy Dermatol Alergol. 2022 Dec;39(6):1151-1156. doi: 10.5114/ada.2021.112317. Epub 2021 Dec 29.

Authors

Maria Olejnik¹, Kinga Adamska², Zygmunt Adamski², Barbara Dorocka-Bobkowska¹

Affiliations

¹ Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland.
² Department and Clinic of Dermatology, Poznan University of Medical Sciences, Poznan, Poland.

Abstract

Introduction: Psoriasis is a chronic multifactorial dermatosis with an autoimmune and genetic background, with characteristic periods of remission and exacerbation, affecting up to 3% of the population; it is currently regarded as a systemic disease.

Aim: To investigate the oral health status, including oral mucosal lesion frequency and prosthetic treatment requirements, in psoriatic patients managed with biological therapies.

Material and methods: Forty-two patients diagnosed with psoriasis and managed with biologics were enrolled in this study. All subjects completed a general medical history and a Dermatology Life Quality Index (DLQI) questionnaire. The disease severity was assessed using the Psoriasis Area and Severity Index (PASI) scale and a DLQI questionnaire. To evaluate the oral health status, the following techniques were used: Approximal Plaque Index (API), the Community Periodontal Index (CPI), and the Decayed, Missing, and Filled Teeth (DMFT) index. The oral mucosa evaluation was based on the clinical appearance, location, and morphology of the lesions.

Results: The most common oral lesions in patients with psoriasis were found to be fissured tongue and white coated tongue. Thirteen patients (31%) presented with clinically healthy oral mucosa. Type II (diffuse type) denture stomatitis (DS) was most common amongst psoriatic patients wearing acrylic removable dentures. Most of the subjects required prosthetic treatment (57.1 %) and the removal of calculus (40.5%); however, no one required surgical treatment.

Conclusions: Fissured tongue seemed to be associated with skin lesions in psoriatic patients managed with biological therapies. The need for dental treatment was observed in 71.4% of the patients, with most subjects requiring prosthetic treatment. The study indicated that the diffuse type of DS occurred amongst subjects with psoriasis, who were wearers of acrylic removable dentures.

Keywords: biological therapy; oral mucosa lesions; psoriasis; quality of life.