title: Temporomandibular joint problems and periodontal condition in rheumatoid arthritis patients in relation to their rheumatologic status.
abstract: OBJECTIVE
  There are conflicting reports as to whether patients with rheumatoid arthritis (RA) are at high risk for periodontal disease (PD). However, analogous mechanisms of tissue destruction have been reported for the 2 conditions. The present study was undertaken to determine temporomandibular joint (TMJ) problems and periodontal conditions in patients with RA in relation to their rheumatologic status and identify their periodontal needs.
  
  
  METHODS
  One hundred patients with PD, 50 with RA and 50 without RA, were assigned to 1 of 2 age groups (30 to 39 or 40 to 50 years). The plaque index, bleeding index, clinical attachment loss, radiographic bone loss, tooth loss, and TMJ problems were assessed in the 2 groups. Disease duration, level of erythrocyte sedimentation rate (ESR), Health Assessment Questionnaire, and Verbal Descriptor Pain Scale score were assessed in the RA group.
  
  
  RESULTS
  Patients with RA were predominantly women, with longer illness duration (11.84 years), higher ESR (32.08 mm/hour), and higher scores on the Health Assessment Questionnaire (0.82). Patients with RA were characterized by significant increases in clinical attachment loss (3.24 mm), bone loss (1.79 mm), missing teeth (6.22), and TMJ problems (54%) than controls. Their periodontal status significantly correlated with illness duration, Health Assessment Questionnaire score, and Verbal Descriptor Pain Scale score. However, no difference in plaque index and bleeding index were observed between the RA and control groups. Unexpectedly, 30- to 40-year-old patients with RA had a significantly higher plaque index (1.54) and greater TMJ deviation (15%) than the older subjects.
  
  
  CONCLUSIONS
  Patients with advanced RA are more likely to develop more significant periodontal and TMJ problems compared with patients with PD and without RA. There is a great need to instruct patients with RA to consult a dentist to at least decrease PD severity.
authors.affiliation: Department of Oral Pathology, College of Dentistry, University of Sulaimani, Kurdistan Region, Iraq. balkess_taha@yahoo.com
authors.forename: Balkees Taha
authors.initials: BT
authors.lastname: Garib
authors.forename: Sarhang S
authors.initials: SS
authors.lastname: Qaradaxi
mesh_terms: D000328:Adult; D000367:Age Factors; D016301:Alveolar Bone Loss / Q000209:etiology*; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001799:Blood Sedimentation; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003774:Dental Plaque Index; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010518:Periodontitis / Q000209:etiology*; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000209:etiology*; D016388:Tooth Loss / Q000209:etiology*