Periodontal Condition in Patients with Rheumatoid Arthritis: Effect of Anti-rheumatic Drugs

Statement of the Problem: Rheumatoid arthritis and periodontitis are chronic inflamma-tory diseases with a possible bidirectional relationship. This link may be affected by many factors like drug consumption. Purpose: This study was designed to evaluate the periodontal condition in patients with rheumatoid arthritis, considering the effect of disease modifying anti-rheumatic drugs. Materials and Method: This case-control study included 25 newly diagnosed rheumatoid arthritis patients with negative history of taking anti-rheumatic drugs, 25 patients who received anti-rheumatic drugs for more than three years and 50 healthy individuals as a control group. Periodontal indices, including plaque index, gingival index, probing depth, clinical attachment loss, and rheumatologic indices were recorded and compared between these groups. Results: Rheumatoid arthritis patients were significantly more affected by periodontitis compared with healthy subjects (p= 0.006). There was no significant difference in rheuma-tologic indices between patients with and without periodontitis. Clinical attachment loss in old rheumatoid arthritis patients and gingival index in newly diagnosed ones were signifi-cantly more compared to the control group (p= 0.003 and p< 0.001 respectively). We could not find a linear relationship between the severity of rheumatoid arthritis and chronic peri-odontitis (p= 0.1, r= -0.224). Conclusion: Periodontitis and clinical attachment loss were more in patients with rheuma-toid arthritis than the healthy group, especially in drug consumers. Gingival index in pa-tients without the history of consuming anti-rheumatic drugs was significantly higher than those who were drug consumers, indicating the effect of the medications on the signs of inflammation.