Journal List > J Korean Acad Oral Health > v.38(4) > 1057615

TOOLS
Shin, Kim, Jung, Jung, Kim, Choi, and Song: Relation between rheumatoid arthritis and periodontal diseases: Using the Fifth Korea National Health and Nutrition Examination Survey
Original Article

J Korean Acad Oral Health 2014;38(4):232-237.

Published online: 12 December 2014

DOI: https://doi.org/10.11149/jkaoh.2014.38.4.232

Relation between rheumatoid arthritis and periodontal diseases: Using the Fifth Korea National Health and Nutrition Examination Survey

Hae-Eun Shin1, Ji-Hye Kim1, Yun-Sook Jung1, Eun-Kyung Jung2, Eun-Kyong Kim3, Youn-Hee Choi1, Keun-Bae Song1

1Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea

2Department of Dental Hygiene, Ulsan College, Ulsan, Korea

3Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, Korea

Corresponding Author: Keun-Bae Song Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, 2177 Dalgubeol-daero, Jung-gu, Daegu 700-412, Korea Tel: +82-53-660-6870 Fax: +82-53-423-2947 E-mail: kbsong@knu.ac.kr

Received 6 October 2014       Revised 19 November 2014       Accepted 24 November 2014

Copyright © 2014 Journal of Korean Academy of Oral Health

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

Rheumatoid arthritis (RA) has been associated with systemic diseases, such as periodontal diseases. Periodontal diseases and RA appear to share many pathologic features. The etiology of the two diseases may differ, but they share similar pathological characteristics. Therefore, the aim of this study was to evaluate the correlation between RA and periodontal diseases.

Methods

Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHNES) were used to analyze periodontal status according to the presence of RA. Demographics and oral behaviors were analyzed using the complex chi-square test to compare participants with RA with those without RA. Complex logistic regression was used to analyze relationships of periodontal diseases with RA and other covariates.

Results

The odds ratio for periodontal diseases was 1.91 (95% confidence interval: 1.05-3.48) in participants with RA compared with participants without RA.

Conclusions

The results of this study provide evidence of a significant association between periodontal diseases and RA.

Keywords: Korea National Health and Nutrition Examination Survey (KNHNES), Periodontal diseases, Rheumatoid arthritis (RA)

References

1. Moon HS. Suggestions for professionalization and improvement of oral health ministration in Korea. J Korean Dent Assoc. 1997; 6:351–352.
2. Burt B. Position paper: Epidemiology of periodontal diseases. J Periodontol. 2005; 76:1406–1419.
3. Ji JD, Lee YH, Song GG. Prostaglandin E2 (PGE2): Roles in immune responses and inflammation. J Rheum Dis. 2004; 11:307–316.
4. Arnett F, Edworthy S, Bloch DA, Mc Shane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis and Rheumatism. 1988; 31:315–324.
crossref
5. Harris ED, Kelly WN, Sledge CB. Clinical features of rheumatoid arthritis. Textbook of rheumatology. 5th ed.Philadelphia: WB Saunders;1997. p. 898.
crossref
6. Ji JD, Kim TH, Lee B, Choi SJ, Lee YH, Song GG. Expression of osteoclastogenesis- related genes in rheumatoid arthritis synovial macrophages. J Rheum Dis. 2011; 18:11–18.
7. Lee L, Manolisos N. Therapeutic horizons for rheumatoid arthritis. Today's Life Science. 1999; 11:42–48.
8. Silman AJ. Commentary: do genes or environment influence development of rheumatoid arthritis? Br Med J. 2002; 324:264.
9. Yavuzyilmaz E, Yamalik N, Calguner M, Ersoy F, Baykara M, Ye-niay I. Clinical and immunological characteristicsof patients with rheumatoid arthritis and periodontal disease. J Nih on Univ Sch Dent. 1992; 34:89–95.
10. Sjostrom L, Laurell L, Hugoson A. Hakansson J. Periodontal conditions in adults with rheumatoid arthritis. Comm Dent Oral Epidemiol. 1989; 17:234–236.
11. Kasser UR, Gleissner C, Dehne F, et al. Risk for periodontal disease in patients with longstanding rheumatoid arthritis. Arth ritis Rheum. 1997; 40:2248–2251.
12. Albandar JM. Some predictors of radiographic alveolar bone height reduction over 6 years. J Periodont Res. 1990; 25:186–192.
crossref
13. Pischon N, Pischon T, Kroger J, Gulmes E, Kleber BM, Berni-moulin JP, et al. Association among rheumatoid arthritis, oral hygiene, and periodontitis. J Periodontol. 2008; 79:979–986.
crossref
14. Williams RC, Offenbacher S. Periodontal medicine: the emergence of a new branch of periodontology. Periodontol 2000. 2000; 23:9–12.
crossref
15. Eversole JL. Systemic humoral immune response in periodontal disease. Crit Rev Oral Biol Med. 1990; 1:283–331.
16. Ministry of Health and Welfare. 2012 Korean National Health and Nutrition Examination Survey. Seoul: Ministry of Health and Welfare;2012. p. 3–21.
17. Pischon N, Heng N, Bernimoulin JP, Kleber B, Willich S, Pischon T. Obesity, inflammation, and periodontal disease. J Dent Res. 2007; 86:400–409.
crossref
18. Albandar JM. Epidemiology and risk factors of periodontal diseases. Dent Clin North Am. 2005; 49:517–532.
crossref
19. Merchant AT, Pitiphat W, Franz M, Joshipura K. Whole-grain and fiber intakes and periodontitis risk in men. Am J Clin Nutr. 2006; 83:1395–1400.
crossref
20. Elliot D, Robert A, Greenwald Laura J, Kushner Gerald W. Hypothesis: The humoral immune response to oral bacteria provides a stimulus for the development of rheumatoid arthritis. Inflammation. 2004; 6:311–318.
crossref
21. Ribeiro J, Leao A, Novaes AB. Periodontal infection as a possible.
22. Mercado FB, Marshall RI, Bartold PM. Inter-relationships between rheumatoid arthritis and periodontal disease. J Clin Peri-odontol 2003;30:761-772. severity factor for rheumatoid arthritis. J Clin Periodontol. 2005; 32:412–416.
23. Snyderman R, McCarty GA. Analogous mechanism of tissue destruction in rheumatoid arthritis and periodontal disease. Genco RJ, Mergenhagen SE, editors. Host parasite interactions in periodontal diseases. Washington DC: American Society for Mi-crobiology;1982. p. 354–362.
24. De Pablo F, Chapple ILC, Christopher D, Buckley CD, Thomas D. Periodontitis in systemic rheumatic diseases. Rheumatology. 2009; 5:218–224.
crossref
25. Mercado F, Marshall RI, Klestov AC, Bartold PM. Is there a relationship between rheumatoid arthritis and periodontal disease? J Clin Periodontol. 2000; 27:267–272.
crossref
26. De Pablo F, Dietrich T, McAlindon TE. Association of periodontal disease and tooth loss with rheumatoid arthritis in the US population. J Rheumatol. 2008; 35:70–76.
27. Eduardo PI, Manoel BB, Carlos R, Keith LK, Mirian AO. Peri- odontal condition in patients with rheumatoid arthritis. Brax Oral Res. 2008; 22:72–77.
28. Dissick A, Redman RS, Jones M, Rangan BV, Reimold A, Griffiths GR, et al. Association of periodontitis with rheumatoid arthritis: a pilot study. J Periodontol. 2010; 81:223–230.
crossref
29. Kasser UR, Gleissner C, Dehne F, Michel A, Willershausen-Zonnchen B, Bollten WW. Risk for periodontal diseases in patients with longstanding rheumatoid arthritis. Arthritis Rheum. 1997; 40:2248–2251.
30. Nasse W, Dijkstra PU, Abbas F, Spijkervet FKL, Stijger A, Tromp JAH, et al. Increased prevalence of cardiovascular and autoimmune diseases in periodontitis patients: a cross-sectional study. J Periodontol. 2010; 81:1622–1628.
31. Tolo K, Jorkjend L. Serum antibodies and loss of periodontal bone in patients with rheumatoid arthritis. J Clin Periodontol. 1990; 17:288–291.
crossref

Fig. 1.
Flow chart.
jkaoh-38-232f1.tif
Table 1.
Demographic distribution according to rheumatoid arthritis and intra oral condition
Non-RA (n=4355) RA (n=92) P-value*
n (%) n (%)
Age
≤65 3,575 (91.0) (69.4) 57 <0.001
65< (9.0) 780 (30.6) 35
Gender
Male 2,030 (53.8) (21.9) 17 <0.001
Female 2,325 (46.2) (78.1) 75
BMI
Under&normal 2,957 (67.0) (62.7) 59 0.550
Overweight 1,398 (33.0) (37.3) 33
Frequency of drinking
<1 per month 1,787 (36.2) (57.2) 58 0.001
1 per month≤ 2,568 (63.8) (42.8) 34
Smoking
None 2,404 (49.7) (74.3) 72 0.002
Done or do 1,816 (50.3) (25.7) 20
Periodontal diseases
No 3,285 (78.4) (65.4) 64 0.030
Yes 1,070 (21.6) (34.6) 28

RA, rheumatoid arthritis. The data were analysed by complex samples. *Chi-square test.

Table 2.
Demographic distribution according to periodontal diseases
Non-PD (n=3349) PD (n=1098) P-value*
n (%) n (%)
Age <0.001
≤65 2,885 (93.5) (80.6) 747
65< (6.6) 464 (19.4) 351
Gender <0.001
Male 1,401 (49.8) (65.7) 646
Female (50.2) 1948 (34.3) 452
BMI <0.001
Under&normal 2,334 (68.6) (60.7) 682
Overweight 1,015 (31.4) (39.3) 416
Frequency of drinking 0.900
<1 per month 1,411 (37.3) (33.7) 434
1 per month≤ 1,938 (62.7) (66.3) 664
Smoking <0.001
None 2,009 (53.8) (37.0) 467
Done or do 1,340 (46.2) (63.0) 637

PD, Periodontal diseases. The data were analysed by complex samples. *Chi-square test.

Table 3.
Oral health behavior and rheumatoid arthritis condition
Non-RA (n=3349) RA (n=92) P-value*
n (%) n (%)
Experience of dental examination for the 0.850
last 1 year
No 3,235 (75.0) (77.7) 76
Yes 1,118 (25.0) (22.3) 16
Brushing frequency 0.060
≤1 470 (10.6) 9 (6.7)
2 1,701 (38.5) (53.9) 45
3 1,500 (35.5) (25.9) 26
4≤ 655 (15.4) 12 (13.4)
Dental floss 0.930
No 3,402 (78.6) (79.0) 72
Yes 953 (21.4) 20 (21.0)
Interdental brush 0.250
No 3,434 (80.5) (85.5) 78
Yes 921 (19.5) 14 (14.5)
Mouth rinsing solution 0.110
No 3,521 (80.2) (88.3) 82
Yes 834 (19.8) 10 (11.7)
Electric toothbrush 0.170
No 4,045 (92.9) (88.7) 83
Yes 310 (7.1) 9 (11.3)

RA, rheumatoid arthritis

*Chi-square test.

Table 4.
Associations of rheumatoid arthritis and individuals characteristics
Characteristic OR (95% CI) for periodontal diseases
RA
No 1.00 (reference)
Yes 1.93 (1.05-3.53)*
Gender
Female 1.00 (reference)
Male 1.94 (1.63-2.30)*
Age
≤65 1.00 (reference)
65< 3.42 (2.80-4.18)*
Frequency of drinking
<1 per month 1.00 (reference)
1 per month≤ 1.17 (0.98-1.40)
Smoking
None 1.00 (reference)
Done or do 1.99 (1.65-2.40)*

RA, rheumatoid arthritis. OR, odds ratio; CI, 95% confidence intervals. *Logistic regression.

Table 5.
Relationship between periodontal health and rheumatoid arthritis
Unadjusted Age+Gender adjusted Age+Gender+Smoking adjusted
OR (95% CI) OR (95% CI) OR (95% CI)
Non-RA 1.00 (reference) 1.00 (reference) 1.00 (reference)
RA 1.93 (1.05-3.53)* 1.88 (1.02-3.45)* 1.91 (1.05-3.48)*

RA, rheumatoid arthritis; OR, odds ratio; CI, 95% confidence intervals. *Logistic regression.

TOOLS
Similar articles