Background/Purpose: Oral health is an important issue for patients with rheumatoid arthritis (RA) because periodontitis is a potential risk factor for RA and RA patients have been reported to have a significantly increased incidence of periodontitis compared to healthy individuals. We previously reported that 40% of Japanese RA patients disclosed receiving dental treatment in the previous 6 months (J Bone Miner Metab, 2017; 35: 344-350). Limited data exist in the literature concerning periodontitis in Japanese RA patients. This study aimed to evaluate periodontitis in our Institute of Rheumatology Rheumatoid Arthritis (IORRA) cohort.

Methods: The IORRA cohort was established in 2000 as a single institute-based large cohort of Japanese RA patients. More than 122 publications have described various characteristics of Japanese RA patients using this cohort. Patients with RA enrolled in the IORRA cohort completed self-administered questionnaires as part of the 2016 October/November IORRA surveys, which included gingival bleeding during tooth brushing and periodontitis diagnosed by dentists in the previous 6 months (April to September 2016). Logistic regression analyses were used to evaluate associations between gingival bleeding during tooth brushing, periodontitis, and clinical variables.

Results: Among 5,660 Japanese patients with RA who participated in the cohort (median age, 62 years old; females, 86%), 31% and 18% reported having gingival bleeding during tooth brushing and periodontitis diagnosed by a dentist, respectively, in the previous 6 months. Among 1,211 patients with RA treated with anti-resorptive drugs (bisphosphonates and denosumab) (median age, 69 years old; females, 95%), 26% and 19% reported having gingival bleeding during tooth brushing and periodontitis diagnosed, respectively, in the previous 6 months. Among Japanese patients with RA, younger age, ever-smoker status, disease activity score (DAS) 28, and Japanese health assessment questionnaire disability index (JHAQ-DI) were significantly associated with gingival bleeding during tooth brushing, and older age, female sex, ever-smoker status, DAS28, and JHAQ-DI were significantly correlated with periodontitis (Table). Among Japanese RA patients treated with anti-resorptive drugs, younger age and patient general visual analogue scale (VAS) were significantly associated with gingival bleeding during tooth brushing, and older age was associated with periodontitis diagnosis in the previous 6 months.

Conclusion: In Japanese patients with RA, many patients experienced gingival bleeding during tooth brushing and were diagnosed with periodontitis by dentists. Age, female sex, ever-smoker status, general health status, disease activity, and disability may be associated with peridontitis in Japanese patients with RA.

Table. Factors associated with gingival bleeding during tooth brushing and periodontitis

Odds ratios (95% confidence intervals)

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/gingival-bleeding-and-periodontitis-in-japanese-patients-with-rheumatoid-arthritis-results-from-the-iorra-cohort-study/