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Rheumatoid arthritis patients rate how oral health affects quality of life

Researchers recommend the creation of epidemiological surveillance systems to monitor and improve oral health and quality of life for patients with rheumatoid arthritis. (Image: Witsawat.S/Shutterstock)

MADRID, Spain/MEDELLÍN, Colombia: Researchers have evaluated the relationship between oral health-related quality of life (OHRQoL) and rheumatoid arthritis (RA) with the goal of promoting multidisciplinary research on prevention for patients with chronic disease. They found that physical pain, disability and psychological distress had the most significant effect on OHRQoL for RA patients with and without periodontitis (PD), but that PD greatly contributed to the disability and distress reported.

PD and RA are chronic diseases currently considered to be linked epidemiologically and biologically as well as in their aetio-pathology. Both diseases result in destruction of bone and connective tissue. RA affects between 0.2% and 5.0% of people globally and is four times more common in women than in men. According to the World Health Organization, severe cases of periodontal diseases affect around 19% of the world’s population.

Evaluation of 59 study participants included a full periodontal examination and administration of a questionnaire. The questionnaire covered socio-demographic information and OHRQoL, assessed via the Oral Health Impact Profile-14 (OHIP-14) instrument, which covered the dimensions of physical pain, physical, social and psychological disability, psychological discomfort, functional limitations and handicap.

The results indicated that socio-economic status and level of family support were directly connected to perceived health status and OHRQoL. Age was statistically significantly correlated with physical and psychological disability. Patients who also had PD reported having higher physical pain and greater psychological disability. The fewer the number of teeth, the poorer the scores on the physical, social and psychological disability and handicap dimensions.

However, according to the participants’ responses to the OHIP-14, oral health had a limited impact on their overall health-related quality of life. The type of RA, the number of affected joints and morning stiffness affected quality of life more than anything else. The factors that were most significant to OHRQoL were how advanced the participant’s PD was, whether there was bleeding on probing and the number of remaining teeth.

The team also found that OHRQoL was negatively affected in patients who reported that they did not regularly exercise. The researchers suggested that this may be attributed to the perception of good oral health and the capability of self-care that arise from general well-being as a consequence of physical exercise improving RA symptoms.

Because certain factors such as type of RA and severity of PD had a strong impact on OHRQoL in the study, the researchers recommended the creation of “epidemiological surveillance systems targeting oral health and systemic conditions [which could] improve the monitoring of these patients and contribute to their general, social, and health well-being and improve their quality of life”.

The study, titled “Oral health-related quality of life in a group of patients with rheumatoid arthritis”, was published in the January–March 2023 issue of Dental and Medical Problems.

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