title: Control of periodontal infection reduces the severity of active rheumatoid arthritis.
abstract: OBJECTIVE
  To determine if eliminating periodontal infection and gingival inflammation affects the severity of active rheumatoid arthritis (RA) in patients with chronic inflammatory periodontal disease.
  
  
  METHODS
  Twenty-nine subjects with confirmed diagnosis of RA and mild-to-moderate chronic periodontitis of at least 3 years' duration were enrolled in the study. The activity of RA was assessed using the disease activity score test (DAS28). Seventeen subjects completing the study received periodontal treatment consisting of scaling/root planing and oral hygiene instruction; 12 subjects completing the study received no treatment. Participants continued their usual disease-modifying medications for RA without any changes in DMARD therapy during the study period. RA measurements, and periodontal indices were recorded at baseline and at 8 weeks for each participant. Mann-Whitney U and chi tests were used to test for significant differences in the severity of RA in the periodontally treated group compared with the untreated groups.
  
  
  RESULTS
  Ten of 17 subjects (58.8%) in the treated group and 2 of 12 subjects (16.7%) in the untreated group showed improvement in RA scores. There was a statistically significant difference in DAS28 (4.3 +/- 1.6 vs. 5.1 +/- 1.2) and erythrocyte sedimentation rate (31.4 +/- 24.3 vs. 42.7 +/- 22) between the treatment and the control groups.
  
  
  CONCLUSIONS
  Control of periodontal infection and gingival inflammation by scaling/root planing and plaque control in subjects with periodontal disease may reduce the severity of RA. This notion is supported by reported subjective improvement in treated patients.
authors.affiliation: Department of Periodontics, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA.
authors.forename: Mhd Khaldoun
authors.initials: MK
authors.lastname: Al-Katma
authors.forename: Nabil F
authors.initials: NF
authors.lastname: Bissada
authors.forename: Judith M
authors.initials: JM
authors.lastname: Bordeaux
authors.forename: J
authors.initials: J
authors.lastname: Sue
authors.forename: Ali D
authors.initials: AD
authors.lastname: Askari
mesh_terms: D001172:Arthritis, Rheumatoid / Q000628:therapy*; D001424:Bacterial Infections / Q000517:prevention & control*; D001799:Blood Sedimentation; D003773:Dental Plaque / Q000517:prevention & control; D012534:Dental Scaling; D005260:Female; D005891:Gingivitis / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D010353:Patient Education as Topic; D010510:Periodontal Diseases / Q000628:therapy*; D010865:Pilot Projects; D016745:Root Planing; D012720:Severity of Illness Index; D016896:Treatment Outcome