The prevalence of patients with rheumatic diseases and its periodontal condition: data from a population-based study in the Lisbon Metropolitan Area

Abstract

Introduction: Periodontitis is a major condition associated with rheumatic diseases (RDs) [1] and some studies have clarified the effect of the oral microbiome in RDs [2,3]. However, due to the lack of information this observational study aimed to describe the periodontal status of RDs in a sample of patients from a population-based epidemiologic survey carried out in the southern Lisbon Metropolitan Area. Materials and Methods: From December 2018 to April 2019, a total of 1064 patients, from public health centres of Almada-Seixal Group of Centres, were randomly enrolled in the study. RDs were assessed through a medical history and medication questionnaire. Periodontitis and Gingivitis were circumferentially evaluated according to the 2018 World Case Definitions [4,5] by two calibrated examiners (J.B. and V.M). This study was approved by the ARSLVT Ethics Committee (3525 & 8696/CES/2018). Results: Overall, the prevalence of rheumatic conditions was 2.8% (95% CI: 1.8-3.8%) (n=30). Individual RD prevalence distribution in the study group were as follows: rheumatoid arthritis (RA) 23.3% (n=7), fibromyalgia (FM) 36.7% (n=11), systemic lupus erythematosus (SLE) 10.0% (n=3), arthritis (ART) 13.3% (n=4), gout 3.3% (n=1), systemic scleroderma 3.3% (n=1), FM+osteoarthritis (OA) 3.3% (n=1), FM+SLE 3.3% (n=1), FME+OA+ART 3.3% (n=1). The prevalence of periodontitis among RD patients was 60% (n=18), with 13.3% (n=4), 16.7% (n=5) and 26.7% (n=8) of mild, moderate and severe stages, respectively. Gingivitis cases were residual, 3.3% (n=1). The average missing teeth were 10.7 (±6.8) and the mean percentage of probing depth ≥4mm was 5.7% (±10.9%). Discussion and conclusions: Despite the low incidence of RDs, these results reveal a considerable high prevalence of periodontitis and gingivitis among those patients. Also, the average number of missing teeth is worrisome. These findings unveil a very disturbing high burden of periodontitis in this sample of Portuguese rheumatic patients and roots basis for future public health measures implementation.