Increased dental visits in patients with rheumatoid arthritis: a secondary cohort analysis of population based claims data

Abstract

Objective To study the utilization of dental care in patients with rheumatoid arthritis (RA) and compare the incidence of common dental disorders in patients with and without RA. Methods This data used in this study was from the population-based Taiwan's National Health Insurance Research Database. We identified 1337 patients with newly diagnosed RA between January 2000 and December 2012. We also identified 13,370 individual without a diagnosis of RA using frequency matching on 5-year age intervals, sex, and index year. Patients with a diagnosis of primary Sjögren's syndrome were excluded. Dental disorders were identified using respective ICD-9-CM codes confirmed by dentists. The incidence and incidence rate ratio [IRR] of each dental disorders were calculated using Poisson regression. Results Compared with the comparison cohort, the prevalence of dentist visits in the RA cohort were significantly higher (70.3% vs. 66.7%, p = 0.008) and the frequency of dentist visits in the RA cohort were also significantly higher (median 2.67 vs. 1.78 per year, p < 0.001). In addition, the incidence of visits for dental caries (adjusted IRR 1.16, p < 0.001), pulpitis (adjusted IRR 1.12, p = 0.044), gingivitis (adjusted IRR 1.13, p = 0.027), periodontitis (adjusted IRR 1.13, p = 0.004), and oral ulcer (adjusted IRR 1.24, p = 0.003) were higher in patients with RA. Conclusions An elevated prevalence and frequency of dental visits were associated with patients with RA. In addition, elevated incidence of dental disorders, including dental caries, pulpitis, gingivitis, periodontitis, and oral ulceration, were observed. Oral health should be accessed regularly in patients with RA.

Exploring the causal relationships between rheumatoid arthritis and oral phenotypes: a genetic correlation and Mendelian randomization study

“…Our study offers epidemiological evidence for the association between RA and mouth ulcers from a genetic perspective. Similarly, a cohort analysis indicated a higher incidence of mouth ulcers in the RA population [adjusted HR (hazard ratio) = 1.24, p = 0.003] ( Juan et al, 2022 ). A real-world study revealed that mouth ulcers were associated with an increased risk of RA, suggesting that mouth ulcers may act as early indicators of systemic autoimmune conditions (HR = 1.19, p = 0.003) ( Lee et al, 2021 ).…”

“…Oral manifestations of RA have attracted increasing attention owing to their prevalent occurrence ( Silvestre-Rangil et al, 2016 ). Significantly, population-based research revealed a higher frequency of dental consultations in RA patients and an elevated prevalence of various dental pathologies ( Juan et al, 2022 ). A meta-analysis demonstrated an increased risk of RA in individuals with periodontal disease, which was notably more pronounced in instances of prolonged disease duration ( Qiao et al, 2020 ).…”