Periodontitis in Italian patients with established rheumatoid arthritis: A cross-sectional study

Oral Dis. 2022 Sep;28(6):1715-1722. doi: 10.1111/odi.13842. Epub 2021 Mar 21.


Objective: To assess the prevalence and severity of periodontitis (P) among Italian patients affected by rheumatoid arthritis (RA).

Materials and methods: A full-mouth periodontal examination and a rheumatologic examination were performed. RA disease activity was scored using the DAS28. Serum analyses investigated levels of rheumatoid factor, anti-citrullinated protein antibodies (ACPAs), C-reactive protein, erythrocyte sedimentation rate and fibrinogen. Information concerning smoking, body mass index and RA medical therapy was collected. Data were analysed by Student's t test, chi-square test, binary logistic regression and Spearman's rank.

Results: This cross-sectional study included 120 subjects, 77 had both diseases while 43 only had RA. The number of teeth present was statistically lower in the RA-P compared to the RA group (p < .05). There were statistically more subjects seropositive for ACPAs in the RA-P group (62.3% vs. 32.6%, p < .05). RA-P patients had an adjusted OR = 2.9 of presenting a moderate-severe DAS28 score (DAS28 ≥ 3.2).

Conclusions: Higher prevalence of severe P was noted among RA subjects. The clinical severity of RA was strongly correlated with the clinical periodontal parameters, and RA subjects also affected by P had an OR of 2.9 for presenting with a moderate-severe RA (DAS28 score ≥ 3.2).

Keywords: Italian; disease activity; periodontitis; prevalence; rheumatoid arthritis.

MeSH terms

  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / epidemiology
  • Autoantibodies
  • C-Reactive Protein / analysis
  • Cross-Sectional Studies
  • Humans
  • Periodontitis* / complications
  • Periodontitis* / epidemiology


  • Autoantibodies
  • C-Reactive Protein