Association of periodontal disease and tooth loss with rheumatoid arthritis in the US population.
OBJECTIVE
To test for an association of periodontitis and tooth loss with rheumatoid arthritis (RA).


METHODS
The third National Health and Nutrition Examination Survey (NHANES III) is a nationally representative cross-sectional survey of noninstitutionalized civilians. We included participants aged > or = 60 years who had undergone both musculoskeletal and dental examinations. RA was defined based on American College of Rheumatology criteria. Dental examinations quantified decayed and filled surfaces, missing teeth, and periodontitis. Periodontitis was defined as at least 1 site exhibiting both attachment loss and a probing depth of > or = 4 mm. We classified dental health status as (1) no periodontitis, (2) periodontitis, or (3) edentulous (i.e., complete tooth loss). We performed multivariate multinomial logistic regression models with dental health status as the dependent and RA as the independent variables.


RESULTS
The sample consisted of 4461 participants, of whom 103 were classified as having RA. Participants with RA had more missing teeth (20 vs 16 teeth; p < 0.001), but less decay (2% vs 4%; p < 0.001) than participants without RA. After adjusting for age, sex, race/ethnicity, and smoking, subjects with RA were more likely to be edentulous [odds ratio (OR) 2.27, 95% confidence interval (CI) 1.56 3.31] and have periodontitis (OR 1.82, 95% CI 1.04 3.20) compared with non-RA subjects. In participants with seropositive RA there was a stronger association with dental health status, in particular with edentulism (OR 4.5, 95% CI 1.2 17).


CONCLUSIONS
RA may be associated with tooth loss and periodontitis.
Division of Rheumatology, Department of Medicine, Tufts New England Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA. pdepablo@tufts-nemc.org
Paola
P
de Pablo
Thomas
T
Dietrich
Timothy E
TE
McAlindon
D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000150:complications / Q000453:epidemiology*; D009749:Nutrition Surveys; D016017:Odds Ratio; D010510:Periodontal Diseases / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D016388:Tooth Loss / Q000150:complications / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology