Association between moderate to severe psoriasis and periodontitis in a Scandinavian population

Abstract

BackgroundThe aim of the present study was to compare the prevalence of periodontitis and alveolar bone loss among individuals with psoriasis and a group of randomly selected controls.MethodsFifty individuals with psoriasis and 121 controls completed a structured questionnaire, and were examined clinically and radiographically. Oral examination included numbers of missing teeth, probing pocket depth (PPD), clinical attachment level (CAL), presence of dental plaque and bleeding on probing, as well as alveolar bone loss from radiographs. Questionnaires requested information on age, gender, education, dental care, smoking habits, general diseases and medicament use. For adjustment for baseline differences between psoriasis individuals and controls the propensity score based on gender, age and education was computed using multivariate logistic regression. A subsample analysis for propensity score matched psoriasis individuals (n = 50) and controls (n = 50) was performed.ResultsWhen compared with controls, psoriasis individuals had significantly more missing teeth and more sites with plaque and bleeding on probing. The prevalence of moderate and severe periodontitis was significantly higher among psoriasis individuals (24%) compared to healthy controls (10%). Similarly, 36% of psoriasis cases had one or more sites with radiographic bone loss ≥3 mm, compared to 13% of controls. Logistic regression analysis showed that the association between moderate/severe periodontitis and psoriasis remained statistically significant when adjusted for propensity score, but was attenuated when smoking was entered into the model. The association between psoriasis and one or more sites with bone loss ≥3 mm remained statistically significant when adjusted for propensity score and smoking and regularity of dental visits. In the propensity score (age, gender and education) matched sample (n = 100) psoriasis remained significantly associated with moderate/severe periodontitis and radiographic bone loss.ConclusionsWithin the limits of the present study, periodontitis and radiographic bone loss is more common among patients with moderate/severe psoriasis compared with the general population. This association remained significant after controlling for confounders.

Periodontitis as another comorbidity associated with psoriasis: A case‐control study

“…Later, observational studies have confirmed these findings . However, they have shown some controversial results and limitations.…”

“…However, they have shown some controversial results and limitations. Among them, the use of retrospective data obtained from medical records, indexes for characterizing periodontitis, small samples, self‐reported information about periodontal, and psoriasis conditions …”

Periodontitis and risk of psoriasis: a systematic review and meta‐analysis

“…One study was excluded because it compared the risk of periodontitis among subjects with and without psoriasis (and did not compare the risk of psoriasis in subjects with and without periodontitis) . Therefore, five studies (two cohort studies and three case–control studies) met the predefined eligibility criteria and were included in the meta‐analysis . The bibliographies of these five studies were manually reviewed for additional relevant studies, but no further studies were identified.…”

Assoziation zwischen Psoriasis und Parodontitis bei der dermatologischen Untersuchung nicht vergessen

“…der chronisch spontanen Urtikaria (csU) und Psoriasis, wird/wurde traditionell eine Fokussuche durchgeführt, die vorrangig Ausschluss, gegebenenfalls Behandlung eines entzündlichen Geschehens im Hals-Nasen-Ohren-Bereich und im Zahn-Mund-Kiefer-Bereich beinhaltet. Während lange Zeit diese Maßnahmen bona fide ohne robuste wissenschaftliche Grundlage durchgeführt wurden, belegen nun zahlreiche kürzlich erschienene Arbeiten [1,2,3,4,5] eine erhöhte Inzidenz von Parodontitis bei Patienten mit Psoriasis gegenüber der Normalbevölkerung und legen eine ähnliche Entzündungskaskade bei beiden Krankheitsbildern nahe.…”