Manual dexterity and plaque accumulation in patients with rheumatoid arthritis

Rheumatoid arthritis (RA) reduces manual dexterity, potentially hindering effective oral hygiene and increasing periodontal risk. However, this relationship has not been fully clarified.

This cross-sectional study included 80 participants (40 with RA and 40 without RA), all diagnosed with gingivitis or periodontitis. The groups were recruited from different settings and were not matched for demographic or systemic characteristics. Periodontal parameters were assessed using full-mouth bleeding score (FMBS), plaque score, probing depth (PD), and clinical attachment loss (CAL). Manual dexterity was evaluated using the Moberg Pick-Up Test (MPUT), comprising four subtests: dominant hand eyes open (DHEO), non-dominant hand eyes open (NdHEO), dominant hand eyes closed (DHEC), and non-dominant hand eyes closed (NdHEC). Associations were analyzed using Spearman's correlation, and multivariable analysis was performed adjusting for age and comorbidities.

Periodontitis was more prevalent in the RA group, whereas gingivitis predominated in the non-RA group (p = 0.001). The plaque score was significantly different between groups (p = 0.036). All MPUT subtests showed significantly poorer performance in the RA group compared with controls (p < 0.05). Within the RA group, NdHEO and NdHEC subtests were associated with plaque scores (p = 0.006, p = 0.005). In multivariable analysis, performance in NdHEC subtest was significantly associated with plaque scores (p = 0.036; OR 0.033, 95% CI 0.001-0.797) after adjustment for age and comorbidities.

Manual dexterity, as assessed by the MPUT, was associated with greater plaque accumulation but not with periodontal severity. While these findings suggest a potential link between functional limitations and oral hygiene in RA patients, a causal relationship cannot be inferred due to the cross-sectional design of this study.