Another study links periodontitis and rheumatoid arthritis

Moderate to severe periodontitis has been linked to the development of rheumatoid arthritis (RA) among non-smokers, according to research presented last week at the American College of Rheumatology Annual Scientific Meeting in Philadelphia.

Researchers from the University of Minnesota set out to determine the risk for developing RA based on periodontitis and to assess the levels of protein-attacking antibodies and rheumatoid factor in these patients. They studied 6,616 people who were a part of a separate epidemiological study who had been examined four times between 1987 and 1998. Each individual was assessed for periodontal disease between 1996 and 1998.

Each participant was characterized as having no, mild, moderate, or severe periodontitis and either prevalent RA (having been hospitalized with a diagnosis of RA within the nine years before their periodontal exam) or new RA (having been hospitalized with a diagnosis of RA within eight years after their periodontal exam). In addition, researchers performed anti-cyclic citrullinated peptide antibody tests on blood samples collected during their study visits.

They found that the risk of developing RA was over twice as high in persons with moderate to severe periodontitis, compared to those with no-mild periodontitis. The risk of developing RA was even higher among non-smokers with moderate to severe periodontitis compared to non-smokers with no to mild periodontitis.

People with peridontitis were also more likely to develop higher levels of the anti cyclic citrullated antibody, which has been associated with more severe, damaging RA. Those individuals with positive anti-cyclic citrullinated antibodies were more likely to have moderate to severe periodontitis and to be smokers than those who did not have both of those putative RA risks.

The researchers concluded that moderate to severe periodontitis may be a risk for developing RA, in non-smokers, and that it may increase the risk of anti-CCP antibody positivity in smokers.

"Moderate to severe periodontitis may also increase the risk of developing rheumatoid arthritis," said Jerry A. Molitor, M.D., Ph.D., associate professor at the University of Minnesota and lead investigator in the study, said in a press release. "Furthermore, among those who smoke, moderate to severe periodontitis may increase the risk of developing a specific type of antibodies associated with more severe, damaging rheumatoid arthritis.

These studies emphasize the importance of further studies into how periodontitis may predispose to RA and the possible value of dental care in prevention of RA, he concluded.

In a separate study reported earlier this year, Romanian researchers found a similar link between RA and periodontitis.