J Dent Res Dent Clin Dent Prospects. 2020;14(1): 26-36.
doi: 10.34172/joddd.2020.004
PMID: 32454955
PMCID: PMC7235694
  Abstract View: 315
  PDF Download: 352

Clinical Dentistry

Original Article

Non-surgical oral hygiene interventions on disease activity of Rheumatoid arthritis patients with periodontitis: A randomized controlled trial

William Buwembo 1* ORCID logo, Ian Guyton Munabi 1, Mark Kaddumukasa 2, Haruna Kiryowa 1, Muhammad Mbabali 3, Ethel Nankya 4, William Evan Johnson 4, Emmy Okello 2, Nelson K. Sewankambo 2

1 Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala Uganda
2 Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala Uganda
3 Department of Dentistry, School of Health Sciences, Makerere University College of Health Sciences, Kampala Uganda
4 Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA, Boston University, USA
*Corresponding Author; E-mail: wbuwembo@chs.mak.ac.ug


Background. Periodontitis and rheumatoid arthritis have similar epidemiology and pathophysiology. Understanding the interaction between these two diseases is vital in our settings. We set out to assess the effect of oral hygiene interventions on disease activity of rheumatoid arthritis patients with periodontitis in Kampala, Uganda.

Methods. Fifty-eight patients attending an arthritis clinic with rheumatoid arthritis and periodontitis were randomly assigned to either an intervention group or a control group. Patients diagnosed with rheumatoid arthritis at least two years before, who were on the same medication, dose, or formulation for RA treatment during the preceding three months, were included. The patients were >18 years of age, would be available for all the study visits in the next six months, had at least six natural teeth, had periodontal disease classified as Dutch Periodontal Index (DPSI) >3 and provided written informed consent. Those who had a chronic disorder requiring chronic or intermittent use of antibiotics, were pregnant, were lactating, or had intent to become pregnant were excluded. The primary outcome measure was a change in Disease Activity Score of 28 Joints (DAS28 score) in two 3-month follow-up periods after the intervention. The secondary outcome measure was a change in periodontal status.

Results. There was a statistically significant improvement in the DAS-28 score in both the intervention and control arms during the follow-up period (P<0.01). The participants carrying more than one bacterial species had worse DAS-28 scores.

Conclusion. Oral hygiene interventions given to RA patients could drastically improve their RA treatment outcomes, especially in resource-limited settings.

Keywords: DAS-28 score, periodontitis, periodontopathogenic bacteria, pocket depth, rheumatoid arthritis
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Submitted: 10 Oct 2019
Accepted: 20 Dec 2019
ePublished: 18 Mar 2020
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