Factors Influencing Oral Hygiene Management in Patients with Rheumatoid Arthritis

<p>Abstract：Background and Objective : Rheumatoid arthritis (RA) often affects the proximal interphalangeal and metacarpophalangeal joints, which may lead to severe manual dysfunction. Therefore, oral hygiene may be impaired in these patients due to difficulties in brushing their teeth, leading to plaque accumulation and resulting in inflammatory periodontal disease. In this study, we aimed to examine factors affecting oral hygiene management in patients with RA.</p><p>Methods：Subjects with (n=31, mean age, 70.7±1.3 years) and without RA (n=30, mean age, 57.6±2.2 years) participated in this cross-sectional prospective study. A rheumatologist assessed clinical parameters, including the treatment period, Disease Activity Score based on the C-reactive protein level (DAS28-CRP), Steinbrocker stage and functional classifications, Health Assessment Questionnaire (HAQ) score, RA medication, RA surgery, Sjögren’s syndrome symptoms, and temporomandibular joint pain. The same examiner also determined the Decayed, Missing, and Filled Teeth (DMFT) score, Periodontal Index, Plaque Control Record (PCR) score, oral mucosal wetness, saliva production, salivary pH, and maximal mouth opening, and performed detection of periodontopathic and cariogenic bacteria. Oral hygiene habits were assessed using a questionnaire. The effects of rheumatologic parameters on the DMFT and PCR scores were assessed using multivariable linear regression analysis.</p><p>Results：Treatment period, DAS28-CRP, Steinbrocker stage and functional classifications, HAQ scores, and RA medication use predicted the DMFT score, whereas DAS28-CRP, HAQ scores, and steroid use predicted the PCR score.</p><p>Conclusion：Our results show predictability of the oral condition in patients with RA based on clinical rheumatologic parameters.</p>