Original ArticleControl of Periodontal Infection Reduces the Severity of Active Rheumatoid ArthritisAl-Katma, Mhd Khaldoun DDS, MSD*; Bissada, Nabil F. DDS, MSD*; Bordeaux, Judith M. DDS, MSD*; Sue, J MD†; Askari, Ali D. MD† Author Information From the *Department of Periodontics, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio; and †Department of Rheumatology, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Cleveland, Ohio. Reprints: Ali D. Askari, MD, Professor of Medicine, Director of Rheumatology, University Hospitals of Cleveland, 11100 Euclid Avenue, University Circle FOL-5076, Cleveland, OH 44106. E-mail: [email protected]. JCR: Journal of Clinical Rheumatology: June 2007 - Volume 13 - Issue 3 - p 134-137 doi: 10.1097/RHU.0b013e3180690616 Buy Metrics AbstractIn Brief Objective: To determine if eliminating periodontal infection and gingival inflammation affects the severity of active rheumatoid arthritis (RA) in patients with chronic inflammatory periodontal disease. Methods: Twenty-nine subjects with confirmed diagnosis of RA and mild-to-moderate chronic periodontitis of at least 3 years’ duration were enrolled in the study. The activity of RA was assessed using the disease activity score test (DAS28). Seventeen subjects completing the study received periodontal treatment consisting of scaling/root planing and oral hygiene instruction; 12 subjects completing the study received no treatment. Participants continued their usual disease-modifying medications for RA without any changes in DMARD therapy during the study period. RA measurements, and periodontal indices were recorded at baseline and at 8 weeks for each participant. Mann-Whitney U and χ2 tests were used to test for significant differences in the severity of RA in the periodontally treated group compared with the untreated groups. Results: Ten of 17 subjects (58.8%) in the treated group and 2 of 12 subjects (16.7%) in the untreated group showed improvement in RA scores. There was a statistically significant difference in DAS28 (4.3 ± 1.6 vs. 5.1 ± 1.2) and erythrocyte sedimentation rate (31.4 ± 24.3 vs. 42.7 ± 22) between the treatment and the control groups. Conclusion: Control of periodontal infection and gingival inflammation by scaling/root planing and plaque control in subjects with periodontal disease may reduce the severity of RA. This notion is supported by reported subjective improvement in treated patients. This pilot study showed that aggressive local therapy of periodontal disease appears to help signs and symptoms of rheumatoid arthritis. © 2007 Lippincott Williams & Wilkins, Inc.