Disease activity, morning stiffness and missing teeth are associated with oral health-related quality of life in individ
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ORIGINAL ARTICLE
Disease activity, morning stiffness and missing teeth are associated with oral health-related quality of life in individuals with rheumatoid arthritis Gerhard Schmalz 1 & Stefan Noack 1 & Susann Patschan 2 & Daniel Patschan 2 & Gerhard A. Müller 3 & Annegret Rupprecht 1 & Jan Schmickler 1 & Rainer Haak 1 & Dirk Ziebolz 1 Received: 4 November 2019 / Accepted: 23 January 2020 # The Author(s) 2020
Abstract Objectives The aim of this cross-sectional study was to assess oral health-related quality of life (OHRQoL) in patients with rheumatoid arthritis (RA) and its relation to specific RA characteristics. Material and methods Within the oral examination, the need for dental (carious teeth showing cavitation) and periodontal treatment (presence of a probing depth ≥ 3.5 mm) and the number of missing teeth (M-T) were recorded. OHRQoL was assessed with the German short version of the Oral Health Impact Profile (OHIP G14). The disease activity score (DAS28-ESR), disease duration, number of swollen/painful joints and duration of morning stiffness were retrieved from the patient records. Results A total of 176 patients with a mean age of 62.5 ± 10.2 years were included. The overall OHIP G14 sum score was 5.4 ± 7.1. The M-T showed a significant correlation with the dimensions of oral function (r = 0.25, p = 0.001) and psychosocial impact (r = 0.20, p = 0.009) and the sum score (r = 0.26, p = 0.001). The DAS28-ESR showed a significant correlation with psychosocial impact (r = 0.19, p = 0.012) and the sum score (r = 0.16, p = 0.041). The duration of morning stiffness was correlated with oral function (r = 0.19, p = 0.019), psychosocial impact (r = 0.18, p = 0.024) and the sum score (r = 0.22, p = 0.006). The effect size of these correlations was interpreted as small. Conclusion Disease activity, morning stiffness and missing teeth are associated to OHRQoL of patients with RA. Accordingly, multidisciplinary dental care appears necessary for these patients. Clinical relevance The prevention of tooth loss as well as the consideration of psychosocial and disease-specific parameters in the multidisciplinary dental care of RA patients is necessary. Keywords Rheumatoid arthritis . Oral health . Quality of life . Dental care
Introduction
Gerhard Schmalz and Stefan Noack contributed equally as the first author. * Dirk Ziebolz [email protected] 1
Deptartment of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, D 04103 Leipzig, Germany
2
Department of Cardiology, Angiology and Nephrology, Klinikum Brandenburg, Medizinische Hochschule Brandenburg, Neuruppin, Brandenburg, Germany
3
Department of Nephrology and Rheumatology, University Medical Centre Goettingen, Goettingen, Germany
The main objectives in the therapy of rheumatoid arthritis (RA) are to manage inflammation-related pain and to maintain or improve physical function, as well as the quality of life, of patients [1]. This is because patients suffering from RA show distinct changes in their quality of life th
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