Effect of Periodontal Therapy on Rheumatoid Disease Activity in Patients on Anti-Rheumatoid Drugs - A Prospective Study.

Aim: The aim of this clinical trial rheumatoid arthritis-chronic periodontitis (RA-CP) is to assess the effect of non-surgical periodontal therapy in RA patients.

Materials and methods: Sixty RA patients taking disease-modifying anti-rheumatoid drugs (DMARD) with CP were selected from the Institute of Rheumatology, Madras Medical College, randomised into the intervention group (IG) and control group (CG). IG received non-surgical periodontal therapy after the screening visit, but CG did not receive treatment until the 3 months study period. Periodontal parameters were recorded at baseline and after 3 months for both groups. Rheumatoid Disease activity (RD activity) was assessed using disease activity score (DAS28), inclusive of tender joints count (TJC), swollen joints count (SJC), visual analog scale (VAS), and erythrocyte sedimentation rate (ESR) for both groups at baseline and after 3 months.

Results: At the end of 3 months, IG had significant reduction in RA parameters such as tender joints count (0.0005), swollen joints count (0.0005), ESR (0.003), VAS score (0.0005), and DAS28 values (0.0005) compared to CG. Periodontal parameters at the end of 3 months were also significantly reduced in IG than in CG.

Conclusion: Non-surgical periodontal therapy might have reduced the burden of systemic inflammatory markers, thus reducing severity of RA in IG. Reduction in tenderness and swelling of joints in the upper arm might have enabled the patients in IG to perform better oral hygiene maintenance procedures.