Oral health-related quality of life in patients with early rheumatoid arthritis is associated with periodontal inflammation and painful temporomandibular disorders: a cross-sectional study

• Published in: Clinical oral investigations Vol. 26; no. 1; pp. 555 - 563
• Main Authors: Kroese, Johanna M., Volgenant, Catherine M. C., van Schaardenburg, Dirkjan, van Boheemen, Laurette, van Selms, Maurits K. A., Visscher, Corine M., Crielaard, Wim, Loos, Bruno G., Lobbezoo, Frank
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-01-2022; Springer Nature B.V
• Subjects: Arthritis, Rheumatoid - complications; Cross-Sectional Studies; Dentistry; Dentures; Gender; Humans; Inflammation; Medical personnel; Medicine; Oral Health; Oral hygiene; Original; Original Article; Pain; Patients; Quality of Life; Rheumatoid arthritis; Risk groups; Surveys and Questionnaires; Temporomandibular Joint Disorders; Xerostomia; Temporomandibular disorders; Pain; Xerostomia; Oral health; Periodontal health; Quality of life
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-021-04034-z

Objectives
To evaluate oral health-related quality of life (OHRQoL) in early rheumatoid arthritis (ERA) patients and individuals at risk of rheumatoid arthritis (RA) compared to healthy controls, and to explore possible associated factors.
Materials and methods
Fifty ERA patients, 50 at-risk individuals, and 50 age and gender matched healthy controls were recruited. OHRQoL (Oral Health Impact Profile-14 (OHIP-14)); number of decayed, missing, and filled teeth (DMFT); denture use; periodontal inflamed surface area (PISA); xerostomia (xerostomia inventory (XI)); and possible TMD (-pain) diagnoses were recorded. The groups were compared on these variables. Subsequently, backward multiple regression analyses were performed for the ERA and at-risk groups, with OHRQoL as the dependent variable and gender, age, DMFT, denture use, PISA, XI, non-painful TMD, and TMD pain as independent variables.
Results
At-risk individuals had higher XI scores (U = 789.5, z = -3.181, p = 0.001, r = -0.32) and higher prevalence of TMD pain (p = 0.046, OR = 4.57; 95% CI 0.92–22.73) than healthy controls and higher OHIP-14 scores than the ERA group (U = 894.5, z = -2.418, p = 0.016, r = -0.24), while no difference in OHIP-14 was found between the control group and both other groups. For ERA patients, OHRQoL was associated with PISA and TMD pain (R
2
 = 0.498, p < 0.001). For at-risk individuals, OHRQoL was associated with XI score (R
2
 = 0.410, p < 0.001).
Conclusions
Alertness of health professionals to TMD pain and periodontal inflammation in ERA patients and to xerostomia and TMD pain in at-risk individuals is recommended.
Clinical relevance
The results of this study address orofacial aspects that require attention of health professionals in the timeframe around RA onset.
Trial registration:
Dutch National Trial Register (NTR, NTR6362)