Periodontal Disease and Rheumatoid Arthritis

The Evidence Accumulates for Complex Pathobiologic Interactions

Clifton O. Bingham III; Malini Moni


Curr Opin Rheumatol. 2013;25(3):345-353. 

In This Article

Clinical Features and Prevalence of Periodontal Disease

Periodontal disease or periodontitis affects the tissues that surround and secure the teeth, including the gums or gingiva, the ligaments providing support, and the bone into which the tooth is anchored.[13] Periodontal disease is characterized by the progression beyond an initial stage of gingivitis, to a chronic inflammatory process that begins to affect connective tissues surrounding the tooth leading to attachment loss; in the absence of proper treatment, periodontal disease may progress to bone destruction and tooth loss. Clinical characteristics of periodontal disease include bleeding and friable gums, gingival recession, deepening pockets surrounding the tooth (indicating loss of anchoring attachments), and eventual tooth loosening. Periodontal disease has a considerable impact on oral health-related quality of life.[14] Risk factors associated with periodontal disease include smoking, age, dental hygiene, minority status, and socioeconomic status. A recent review summarized the global prevalence estimates of periodontal disease from various populations.[15] The National Health and Nutrition Examination Survey (NHANES) assessment in 2009–2010 conducted a full mouth examination at six sites per tooth and showed the overall rate of periodontal disease in the general US population over age 30 is 47.2%, 30% moderate and 8.5% severe.[16] These estimates were markedly increased compared with prior NHANES-III reports, in which only a partial mouth examination was performed. Several reports have emphasized that the method of oral examination, numbers of sites evaluated, and periodontal disease case definitions considerably influence prevalence estimates.[16,17,18]