title: Association between a history of periodontitis and the risk of rheumatoid arthritis: a nationwide, population-based, case-control study.
abstract: OBJECTIVE
  To investigate the association between the risk of rheumatoid arthritis (RA) and a history of periodontitis.
  
  
  METHODS
  This nationwide, population-based, case-control study used administrative data to identify 13 779 newly diagnosed patients with RA (age ≥16 years) as the study group and 137 790 non-patients with RA matched for age, sex, and initial diagnosis date (index date) as controls. Using conditional logistic regression analysis after adjustment for potential confounders, including geographical region and a history of diabetes and Sjögren's syndrome, ORs with 95% CI were calculated to quantify the association between RA and periodontitis. To evaluate the effects of periodontitis severity and the lag time since the last periodontitis visit on RA development, ORs were calculated for subgroups of patients with periodontitis according to the number of visits, cumulative cost, periodontal surgery and time interval between the last periodontitis-related visit and the index date.
  
  
  RESULTS
  An association was found between a history of periodontitis and newly diagnosed RA (OR=1.16; 95% CI 1.13 to 1.21). The strength of this association remained statistically significant after adjustment for potential confounders (OR=1.16; 95% CI 1.12 to 1.20), and after variation of periodontitis definitions. The association was dose- and time-dependent and was strongest when the interval between the last periodontitis-related visit and the index date was <3 months (OR=1.64; 95% CI 1.49 to 1.79).
  
  
  CONCLUSIONS
  This study demonstrates an association between periodontitis and incident RA. This association is weak and limited to lack of individual smoking status.
authors.affiliation: Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Hsin-Hua
authors.initials: HH
authors.lastname: Chen
authors.forename: Nicole
authors.initials: N
authors.lastname: Huang
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Chen
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Lee
authors.forename: Yiing-Jenq
authors.initials: YJ
authors.lastname: Chou
authors.forename: Joung-Liang
authors.initials: JL
authors.lastname: Lan
authors.forename: Kuo-Lung
authors.initials: KL
authors.lastname: Lai
authors.forename: Ching-Heng
authors.initials: CH
authors.lastname: Lin
authors.forename: Der-Yuan
authors.initials: DY
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010518:Periodontitis / Q000453:epidemiology*; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult