title: A prospective study of periodontal disease and risk of rheumatoid arthritis.
abstract: OBJECTIVE
  To test for an association between periodontal disease (PD) and incident rheumatoid arthritis (RA) in a large prospective cohort.
  
  
  METHODS
  We conducted a prospective analysis of history of periodontal surgery, tooth loss, and risk of RA among 81,132 women in the Nurses' Health Study prospective cohort. Periodontal surgery and tooth loss were used as proxies for history of PD. There were 292 incident RA cases diagnosed from 1992 to 2004. Information on periodontal surgery and tooth loss in the past 2 years was collected by questionnaire in 1992. Cox proportional hazards models were used to assess relationships between periodontal surgery, tooth loss, and risk of RA adjusting for age, smoking, number of natural teeth, body mass index, parity, breastfeeding, postmenopausal status, postmenopausal hormone use, father's occupation, and alcohol intake.
  
  
  RESULTS
  Compared with those who reported no history of periodontal surgery or tooth loss, women with periodontal surgery or tooth loss did not have a significantly elevated risk of RA in multivariable-adjusted models (RR 1.24, 95% CI 0.83, 1.83; and RR 1.18, 95% CI 0.47, 2.95, respectively). In analyses stratified by ever and never-smokers, ever-smokers with periodontal surgery had an increased risk that was also nonsignificant. Those with severe PD (both history of periodontal surgery and tooth loss) did not have a significant increased risk.
  
  
  CONCLUSIONS
  In this large cohort of American women, there was no evidence of an increased risk of later-onset RA among those with a history of periodontal surgery and/or tooth loss.
authors.affiliation: Department of Epidemology, Harvard School of Public Health, Boston, MA, USA. earkema@post.harvard.edu
authors.forename: Elizabeth V
authors.initials: EV
authors.lastname: Arkema
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Karlson
authors.forename: Karen H
authors.initials: KH
authors.lastname: Costenbader
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009726:Nurses; D010510:Periodontal Diseases / Q000150:complications*; D011446:Prospective Studies; D012307:Risk Factors; D016388:Tooth Loss / Q000150:complications / Q000209:etiology