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Costa AA, Cota LOM, Esteves Lima RP, Oliveira AMSD, Cortelli SC, Cortelli JR, Cyrino RM, Mendes VS, Silva TA, Costa FO. The association between periodontitis and the impact of oral health on the quality of life of individuals with psoriasis and psoriatic arthritis. PLoS One 2024; 19:e0301158. [PMID: 38917108 PMCID: PMC11198795 DOI: 10.1371/journal.pone.0301158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE To evaluate the association between psoriasis (PSO), psoriatic arthritis (PsA) and periodontitis (PE), and the Oral Health-Related Quality of Life (OHRQoL) impacts on individuals with psoriatic disease's daily activities compared to the non-psoriatic ones. MATERIALS & METHODS 296 individuals with psoriatic disease (PSO n = 210, APS n = 86) (cases) and 359 without these diseases (controls) were included. Complete periodontal examinations and collection of variables of interest were performed. The Brazilian version of the Oral Impacts on Daily Performance (OIDP) instrument was applied. RESULTS The prevalence of PE was higher in PsA (57.0%; OR = 2.67 95%CI 1.65-4.32; p<0.001) than in PSO (34.3%; OR = 1.05 95% CI 0.73-1.51; p<0.001) compared to controls (33.1%). Both PsA and PSO groups showed more sites and teeth with 4-6mm probing depth (PD) and had higher OIDP scores than controls (p<0.001), thus indicating worse self-reported quality of life. PE, PSO+PE and consumption of alcohol/anxiolytics significantly influenced OHRQoL (p<0.05). The influence of periodontal parameters on OHRQoL was observed for the presence of PE; PD >6 mm; clinical attachment level >6 mm; higher plaque index, % sites and teeth with bleeding on probing (p<0.05). CONCLUSION Negative impacts of PE on the OHRQoL were demonstrated. The ones having PSO and especially PsA and PE presented significantly worse indicators.
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Affiliation(s)
- Amanda Almeida Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Rafael Paschoal Esteves Lima
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | | | - Sheila Cavalca Cortelli
- Department of Dentistry, Periodontics Research Division, Universidade de Taubaté, São Paulo, Brazil
| | - José Roberto Cortelli
- Department of Dentistry, Periodontics Research Division, Universidade de Taubaté, São Paulo, Brazil
| | - Renata Magalhães Cyrino
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Victor Silva Mendes
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Tarcília Aparecida Silva
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
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Mishra S, Johnson L, Kaushal L, Upadhyay P. Impact of periodontitis on oral health-related quality of life of patients with psoriatic arthritis. SPECIAL CARE IN DENTISTRY 2024; 44:893-902. [PMID: 37919245 DOI: 10.1111/scd.12938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Since oral health issues can have a negative influence on a person's physical functioning, social status, and wellbeing, oral health-related quality of life (OHRQoL) becomes an indispensable part of overall health. Previous published studies report that periodontitis (PD) and psoriatic arthritis (PsA) have a significant negative impact on OHRQoL. Based on these findings, it would be reasonable to assume that patients with coexisting PsA and PD would see a comparable or maybe synergistic effect on their OHRQoL. Hence, the aim of the present study is to evaluate the OHRQoL and its impact among subjects with concurrent PsA and PD. MATERIAL AND METHODS The present study was a comparative, cross-sectional investigation. A total of 200 participants were categorized into four groups- PD-PsA (n = 50), PsA (n = 50), PD (n = 50), and healthy controls (n = 50). Demographic data and periodontal parameters-plaque index, sites with gingival bleeding, probing pocket depth, gingival recession, and clinical attachment level were recorded for all the four groups. Number of mobile teeth due to periodontitis was recorded for the PSA-PD and PD groups. OHIP-14 questionnaire was administered to all the four groups. Collected data was then subjected to statistical analysis. RESULTS The severity of OHIP-14 summary scores was highest in the PsA-PD group (18.06 ± 11.22) followed by the PD group (17.02 ± 9.99) and lowest in the healthy group (6.32 ± 5.59) (p < .0001). The scores of all the domains- oral pain, oral function, orofacial appearance and psychological impact were highest among the PsA-PD group followed by the PD group (p < .0001). The combined interaction of PsA and PD on the OHRQoL was statistically significant (F = 6.33, p = .012). Results of the multiple linear regression analysis indicated that there was a moderate collective significant effect between age, past dental visit, frequency of daily tooth brushing, use of other oral hygiene aids, and OHIP-14 (F(3,196) = 13.08, p < .001, R2 = 0.17, adjusted R2 = 0.15). CONCLUSION The negative impact on OHRQoL was highest in the patients with concurrent presence of PD with PsA followed by those with PD alone. While the summary scores and dimensional scores of OHIP-14 were insignificant when patients with PsA-PD and PD alone were compared, these scores were significantly higher in patients with PsA-PD than patients with PsA alone.
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Affiliation(s)
- Supriya Mishra
- Department of Periodontics, Government Dental College, Raipur, Chhattisgarh, India
| | - Lynn Johnson
- Department of Periodontics, Rama Dental College, Kanpur, Uttar Pradesh, India
| | - Laxmi Kaushal
- Department of Periodontics, Maitri College of Dentistry and Research Center, Anjora, Durg, Chhattisgarh, India
| | - Palak Upadhyay
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Maitri College of Dentistry and Research Center, Anjora, Durg, Chhattisgarh, India
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Kwak EJ, Choi YJ, Kim HN, Kim KE, Jeon J, Baek YS. Increased dental comorbidities in patients with psoriasis: a nationwide population-based cohort study in Korea. Clin Exp Dermatol 2023; 48:1347-1353. [PMID: 37624999 DOI: 10.1093/ced/llad286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Limited data are available regarding the association between psoriasis and common dental conditions. OBJECTIVES To investigate the risk of potential dental comorbidities in patients with psoriasis. METHODS We conducted a nationwide population-based cohort study to analyse the claims data of patients with psoriasis (n = 15 165) and age- and sex-matched controls (n = 75 825). The incidence risk of the following potential dental conditions was analysed: dental caries, pulp and periapical disease, periodontal disease, gingival changes and tooth loss. RESULTS After adjusting for potential cofactors, the adjusted hazard ratios (aHRs) of dental caries [1.105; 95% confidence interval (CI) 1.078-1.132], pulp and periapical disease (1.07; 95% CI 1.044-1.096) and periodontal disease (1.108; 95% CI 1.088-1.129) were significantly higher than those in the control cohort (P < 0.001). However, among the subset of patients with psoriasis who received systemic antipsoriatic treatment (n = 4275), the aHR risk of all potential dental comorbidities was not significantly higher from that of the control cohort. CONCLUSIONS Patients with psoriasis have an increased risk of dental comorbidities, and systemic antipsoriatic treatment may help mitigate this increased risk.
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Affiliation(s)
- Eun-Jung Kwak
- National Dental Care Center for People with Special Needs, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Yun Jin Choi
- Biomedical Research Institute, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Han-Na Kim
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ko Eun Kim
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jiehyun Jeon
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yoo Sang Baek
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Baek YS, Kwak EJ, Kim YC, Kim KE, Song HJ, Jeon J. Periodontal disease does not increase the risk of subsequent psoriasis. Sci Rep 2023; 13:5942. [PMID: 37046012 PMCID: PMC10097622 DOI: 10.1038/s41598-023-32907-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
Previous studies suggested that chronic periodontitis may be a risk factor for psoriasis. However, no study has confirmed this relationship for all stages of periodontal disease (gingivitis and periodontitis). This nationwide population-based retrospective cohort study aimed to investigate whether periodontal disease is an independent risk factor for the development of subsequent psoriasis. Patients aged ≥ 20 years who underwent both medical and oral checkups from the National Health Screening Program between 2002 and 2007 were selected from a customized database provided by the National Health Insurance Service (NHIS). Then, patients with periodontal disease (n = 3,682,468) and without periodontal disease (control, n = 3,637,128) according to oral examination results were identified. We tracked each patient for subsequent psoriasis diagnosis until the end of 2018 using NHIS database. The incidence rates of psoriasis per 1000 person-years were 0.36 and 0.34 in the periodontal disease group and control groups, respectively. After adjusting for potential cofactors, no significant increase in risk (adjusted hazard ratio, 0.994; 95% confidence interval, 0.974-1.015) was observed. Similar results were observed when analyzing the risk of psoriasis in patients who required scaling or periodontal surgery. In conclusion, periodontal disease is not an independent risk factor of psoriasis.
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Affiliation(s)
- Yoo Sang Baek
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Eun-Jung Kwak
- National Dental Care Center for Person with Special Needs, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Young Chan Kim
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Ko Eun Kim
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Hae Jun Song
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Jiehyun Jeon
- Department of Dermatology, Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea.
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Pro-Inflammatory Oral Microbiota in Juvenile Spondyloarthritis: A Pilot Study. CHILDREN 2022; 9:children9111764. [DOI: 10.3390/children9111764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/01/2022] [Accepted: 11/13/2022] [Indexed: 11/18/2022]
Abstract
The role of the microbiota in the pathogenesis of arthritis is gaining increasing attention. While multiple studies have queried the intestinal microbiota, very few have analyzed the contents of the oral microbiota. In this pilot study, we obtained salivary and sub-gingival specimens from a cohort of six healthy controls and five children with well-controlled spondyloarthritis (SpA) and performed 16S sequencing on bacteria obtained from both habitats. The Quantitative Insight into Microbial Ecology tool suite was used to generate operational taxonomic units, Phyloseq was used for diversity analyses, and DeSeq2 was used to compare abundances while adjusting for multiple comparisons. A repeat specimen was obtained from one subject during a flare. Clustering based upon diagnosis was observed from both habitats, with decreased alpha diversity seen within the plaque obtained from the patients vs. controls. Among the differentially abundant taxa were statistically significantly increased plaque Fusobacterium and salivary Rothia mucilaginosa among the patients compared to the controls. Additionally, the abundance of plaque Fusobacterium increased in one patient at the time of a flare. Our data suggest that the oral cavity may harbor bacteria involved in the pathogenesis of spondyloarthritis; additional studies are warranted.
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Nijakowski K, Gruszczyński D, Kolasińska J, Kopała D, Surdacka A. Periodontal Disease in Patients with Psoriasis: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811302. [PMID: 36141573 PMCID: PMC9516998 DOI: 10.3390/ijerph191811302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 05/05/2023]
Abstract
Psoriasis is a chronic, inflammatory, and recurrent skin disease. As with periodontitis, the development and progression of lesions depend on immunological, genetic, and environmental factors. This systematic review was designed to answer the question: "Is there a relationship between psoriasis and periodontal disease?". Following the inclusion and exclusion criteria, sixteen studies were included in this systematic review (according to PRISMA statement guidelines). Based on the meta-analysis, psoriasis patients showed a more than two-fold increase in the odds of periodontal disease. Almost one-third of these patients suffered from periodontitis of varying severity. Despite the heterogeneity of the included studies, psoriasis is associated with a higher risk of periodontitis, and especially with advanced progression.
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Affiliation(s)
- Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
- Correspondence:
| | - Dawid Gruszczyński
- Student’s Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Julia Kolasińska
- Student’s Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Dariusz Kopała
- Student’s Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
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Sobecka-Frankiewicz M, Rudnicka J, Iwanicka-Grzegorek E, Mielczarek A. Oral changes in patients with psoriasis. Int J Dermatol 2022; 62:604-610. [PMID: 35834660 DOI: 10.1111/ijd.16350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/31/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022]
Abstract
Psoriasis is one of the most frequent skin diseases. The cause of psoriasis is not fully expained as there are many factors (infectious, traumatic, hormonal, and chemical) that may play a role in the manifestation of its symptoms. One of the factors that may contribute to the appearance of psoriatic lesions may be the lesions in the oral cavity. The occurrence of lesions in the oral cavity is defined as rare, what can be explained by their nonspecific clinical image, and also by the possibility of being overlooked. Most characteristic symptoms of psoriasis occurring in the oral cavity are the geographic tongue and fissured tongue. It is also believed that there is a correlation between psoriasis and oral health- the periodontal and teeth condition as well as changes in saliva secretion. The psoriasis arthritis changes can also affect temporomandibular joint and impair the function of stomatognathic system. Because of these reports, cooperation of dermatologists and dentists in psoriasis care seems to be necessary.
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Affiliation(s)
| | - Joanna Rudnicka
- Department of Conservative Dentistry and Endodontics, Warsaw Medical University, Warsaw, Poland
| | - Ewa Iwanicka-Grzegorek
- Department of Conservative Dentistry and Endodontics, Warsaw Medical University, Warsaw, Poland
| | - Agnieszka Mielczarek
- Department of Conservative Dentistry and Endodontics, Warsaw Medical University, Warsaw, Poland
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Olejnik M, Adamski Z, Osmola-Mankowska A, Nijakowski K, Dorocka-Bobkowska B. Oral health status and dental treatment needs of psoriatic patients with different therapy regimes. Aust Dent J 2021; 66 Suppl 1:S42-S47. [PMID: 33891315 DOI: 10.1111/adj.12847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/08/2021] [Indexed: 11/28/2022]
Abstract
The aim of the study was to investigate the dental treatment requirements and oral health status of psoriatic patients with different severities of the disease, managed by different methods, including biological therapies. METHODS One hundred and twenty-seven patients diagnosed with psoriasis were enrolled in this study. All subjects completed a general medical history and a Dermatology Life Quality Index (DLQI) questionnaire. The severity of the disease was assessed using the Psoriasis Area and Severity Index (PASI) scale and a DLQI questionnaire. In order to evaluate the oral health status, the following techniques were used: Approximal Plaque Index (API), the Community Periodontal Index (CPI) and the Decayed, Missing and Filled Teeth (DMFT) index. RESULTS Patients treated with biologicals presented a significantly lower mean CPI index and required no surgical interventions. Subjects managed with topical therapy had significantly more decayed teeth and higher treatment needs. Only 11.3% of patients did not require dental intervention. CONCLUSIONS The study revealed a high need for dental interventions in patients with psoriasis. The type of treatment used may affect the oral health status of patients. However, further investigations are required to explain the significantly lower CPI value in the group treated with biologicals.
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Affiliation(s)
- M Olejnik
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznań, Poland
| | - Z Adamski
- Department and Clinic of Dermatology, Poznan University of Medical Sciences, Poznań, Poland
| | - A Osmola-Mankowska
- Department and Clinic of Dermatology, Poznan University of Medical Sciences, Poznań, Poland
| | - K Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznań, Poland
| | - B Dorocka-Bobkowska
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznań, Poland
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