title: Oral health status in outpatients with rheumatoid arthritis: the OSARA study.
abstract: BACKGROUND
  Observational studies and clinical trials are increasingly highlighting significant associations between periodontitis (chronic, infectious, inflammatory disease affecting tooth supporting tissues) and rheumatoid arthritis (chronic systemic autoimmune disease).
  
  
  OBJECTIVE
  The aim of the study was to describe the dental, periodontal and oral prosthetic status of outpatients with Rheumatoid Arthritis (RA).
  
  
  METHODS
  The study was conducted from June 2010 to March 2011 in the Rheumatology Day Care Department of the University Teaching Hospital, Toulouse. Activity of the RA was defined according to disease activity score 28 (DAS28). 74 subjects with RA were included. Periodontal status was determined using measurements of pocket depth, bleeding on probing and attachment loss. Periodontal Epithelial Surface Area (PESA) and Periodontal Inflamed Surface Area (PISA) were calculated.
  
  
  RESULTS
  The study population was 60.3 ± 11.9 years old with 75.7% women. 48.6% of the subjects had moderate RA (3.2 < DAS28 ≤ 5.1) and 22.2% high RA activity (DAS28 > 5.1); 93.2% were treated by biotherapy. The mean number of natural teeth was 18.9 ± 9.7. The mean number of teeth replaced by removable prostheses was 7.1 ± 10.5. The mean PISA was 291.9 mm(2) ± 348.7 and the PISA:PESA ratio was 33.2% ± 24.2. 94% of patients had periodontitis, which was moderate in 48% and severe in 46%.
  
  
  CONCLUSIONS
  This study highlights the need for prevention and for adequate dental care to improve global and oral quality of life of subjects with rheumatoid arthritis. Given the frequency of periodontitis and some physiopathological hypotheses, clinical trials are needed to assess if periodontal treatment could improve RA biological and clinical parameters.
authors.affiliation: Faculté de Chirurgie Dentaire de Toulouse 3, chemin des maraichers, 31062 TOULOUSE Cedex 9-France, Tel: +335-6125-4719; e-mail : paul.monsarrat@gmail.com.
authors.forename: Paul
authors.initials: P
authors.lastname: Monsarrat
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Vergnes
authors.forename: Alessandra
authors.initials: A
authors.lastname: Blaizot
authors.forename: Arnaud
authors.initials: A
authors.lastname: Constantin
authors.forename: Gabriel Fernandez
authors.initials: GF
authors.lastname: de Grado
authors.forename: Haingo
authors.initials: H
authors.lastname: Ramambazafy
authors.forename: Michel
authors.initials: M
authors.lastname: Sixou
authors.forename: Alain
authors.initials: A
authors.lastname: Cantagrel
authors.forename: Cathy
authors.initials: C
authors.lastname: Nabet