Periodontal condition is associated with disease duration and motoric disabilities in patients with ankylosing spondylitis: results of a cross-sectional study

Rheumatol Int. 2018 May;38(5):855-863. doi: 10.1007/s00296-018-4012-6. Epub 2018 Mar 20.

Abstract

Objective: Recent literature reveals worse periodontal health condition in ankylosing spondylitis (AS). However, roles of AS-related parameters, periodontal condition, and their association appear unclear. This cross-sectional study aimed at investigating dental and periodontal health as well as potentially periodontal pathogenic bacteria in patients with AS compared to healthy control subjects (HC).

Methods: Dental examination comprised dental findings (DMF-T), periodontal probing depth (PPD), bleeding on probing, clinical attachment loss (CAL), papillary bleeding index, and microbiological analysis based on polymerase chain reaction of selected potentially periodontal pathogenic bacteria. Classification of periodontitis severity was based on PPD and/or CAL and divided into no/mild, moderate, and severe periodontitis.

Results: 52 participants with AS and 52 HC were included. 96% of the AS group and 75% of HC had moderate to severe periodontitis (moderate: AS = 26, HC = 34; severe: AS = 23, HC = 5; p < 0.01). Furthermore, a higher number of decayed teeth (D-T) were found in AS compared to HC (p = 0.02). A significant difference between AS und HC was detected for the prevalences of Parvimonas micra (AS = 92%, HC = 71%; p = 0.01), Eubacterium nodatum (AS = 35%, HC = 17%; p = 0.05), and Eikenella corrodens (AS = 96%, HC = 77%; p = 0.01). Bath Ankylosing Spondylitis Metrology Index (BASMI) and disease duration showed significant associations to PPD and CAL (p < 0.01).

Conclusion: Patients with AS show worse dental and periodontal conditions compared to HC. Thereby, prevalence of bacteria related to insufficient oral hygiene was higher in AS. BASMI and duration of AS affect periodontal burden. Accordingly, particular attention considering dental care and oral hygiene in AS patients seems to be reasonable.

Keywords: Ankylosing spondylitis; Immunosuppressive; Medication; Microbiology; Periodontitis.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Cross-Sectional Studies
  • Dental Caries / microbiology*
  • Disability Evaluation
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Mobility Limitation*
  • Motor Activity*
  • Oral Health
  • Periodontitis / diagnosis
  • Periodontitis / microbiology*
  • Periodontium / microbiology*
  • Risk Factors
  • Severity of Illness Index
  • Spondylitis, Ankylosing / complications
  • Spondylitis, Ankylosing / diagnosis
  • Spondylitis, Ankylosing / physiopathology*