Association between tooth loss and clinical complications in rheumatoid arthritis: a pilot study

Rheumatoid Arthritis (RA) is a chronic autoimmune disease that affects the oral cavity, contributing to the development of periodontal disease (PD), an inflammatory condition that has a bidirectional relationship with various systemic conditions and can lead to tooth loss (TL).This study aimed to evaluate whether the number of missing teeth could serve as an additional indicator for the medical team in assessing the association with systemic disease exacerbations.

This pilot study assessed patients with rheumatoid arthritis (RA) using specific protocols, including medical record analysis and a systematic orofacial examination to calculate the Decayed, Missing, and Filled Teeth (DMFT) index. Validated questionnaires were applied, and the disease activity (DAS-28) and functional capacity (HAQ) indices were collected.

The study included 21 patients with a mean DAS28 of 3.12 and a mean HAQ of 1.077. Of these, 7 (33.4%) were in remission, while 14 (66.6%) had some level of disease activity. 10 (47%) had moderate to severe disability due to RA. Statistical analysis identified polypharmacy as a clinically relevant factor associated with tooth loss (p = 0.029; r = 0.48). Additionally, patients with disease activity had higher DMF-T scores. Correspondence analysis indicated that polypharmacy was associated with a higher prevalence of moderate to severe disability (HAQ) and higher DMF-T scores.

It is concluded that there is a relationship between the DMF-T index, RA activity, the number of missing teeth, and the need for polypharmacy, making these data important to be assessed in the clinical routine of RA patients. Additional studies are necessary to explore this association in greater depth and strengthen the evidence base.