A. Ben Salem, M. Brahem, H. Hachfi, R. Sarraj, S. Abdellatif, R. Ben Tekaya, C. Baccouche, Y. Mohamed
2021 Annals of the Rheumatic Diseases  
Background:Rheumatoid arthritis (RA) is a systemic auto immune inflammatory disorder, which primarily affects the synovial joints, but it may have an impact on oral health.Objectives:The present study aimed to describe oral manifestations in patients with Rheumatoid arthritis (RA).Methods:A cross sectional study including RApatients, which consulted or were hospitalized in Rheumatology department in Taher Sfar Hospital of Mahdia Tunisia, during a period of 10 months. The diagnosis of RA was
more » ... nosis of RA was based on ACR/EULAR 2010 criteria. Oral and periodontal examination was practiced by a trained dentist in the same hospital. Oral hygiene, teeth status (missing teeth) and paradental parameters (bleeding index of Loe and Silness (IG), plaque indexed O'Leary (IP) were determined for each patient, to assess oral and periodontal diseases in RA.Results:Our study included 51 patients with an average age of 51.11 years ±12.4 [21-74years].50patients (92.6%of cases) were women and 8patients (14.8%) were diabetic. Only one patient was a smoker. The mean duration of RA was 10.7 years 7.7± [10months-35years]. Rheumatoid factor (RF) was positive in 25 Patients (46.3%of cases). Anti-citrullinated peptide antibody (ACPA) was positive in 32 patients (59.3 %).41patients (75.4%) had radiological impairments and 28(51.9%) had specific deformations of RA. The average disease activity score (DAS28-VS) and (DAS28-CRP) were respectively 4.1±1.5[1.4-7.3] 3.4±1.5 [1.24-6.71]. Oral examination revealed a poor oral hygiene in 36patients (69.2% of cases) and 4.7% of our patients (2 cases) were toothless. Xerostomia was observed in 32 patients (80%). Gingivitis was diagnosed in 26 Patients (52%): localized in 6 patients (26.1%) and generalized in 17 patients (73.9%). 21 patients had periodontitis (41.2%). Basing on bleeding index of Loe and Silness (IG),27 patients (55.1%) had degree 2 and9 patients (18.8 %) had degree 3. Supragingival plaque and subgingival plaque were detected respectively in 45 patients (90 %) and 47 patients (95.9 %). In our study, tooth loss was significantly correlated with increased age (p=0.001) and post-menopausal status (p=0.03). Xerostomia, gingivitis and periodontitis were associated with increased age. But no association was found between oral manifestations and DAS28 nor biological inflammatory parameters.Conclusion:Rheumatoid arthritis is destructive and disabling rheumatism with a great risk to develop dental and periodontal diseases. So, it is important to systematically control oral hygiene of our patients to prevent complications.Disclosure of Interests:None declared
doi:10.1136/annrheumdis-2021-eular.4015 fatcat:kzw3hhjmvvgyhpvnz4ytywk364