SAT0148 Oral care and health in rheumatoid arthritis patients based on a self- assessment questionnaire investigation
Authors: L. L. Strandbygaard, M. Radwan-Oczko, I. Dus, A. M. Thomsen, K. Schmøkel, C. Rasmussen
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Some investigations indicate a higher prevalence of periodontal disease (PD) in rheumatoid arthritis (RA) patients compared to healthy individuals without RA. Significant improvements in clinical parameters and laboratory tests were demonstrated in RA patients following periodontal therapy. Periodontal diseases – gingivitis and periodontitis are inflammatory, multifactorial pathologies of periodontal tissues, which support the teeth. The factor responsible for the inflammation is a plaque with specific bacteria. In gingivitis, which is the first stage of PD, only gingiva is involved. Then in susceptible patients, periodontitis is developing and the deeper laying structures surrounding the teeth are involved and destroyed. The patients' own observation of gingival bleeding strongly indicates gingival disease. The effectiveness of oral hygiene, including self-care, in controlling periodontal health is crucial and supported by several studies. RA patients frequently experience reduced function of fingers and wrists that makes oral hygiene troublesome. <h3>Objectives:</h3> The purpose of this study was to asses RA patient's oral care and health based on a self-assessment questionnaire. <h3>Methods:</h3> Questionnaires were mailed to 300 patients treated for RA in a Danish rheumatology outpatient clinic. <h3>Results:</h3> A total of 164 patients completed the questionnaires. The mean age of patients was 65 years, and the average value of DAS28 was 2,31. Twelve percent were active smokers. The "dry mouth" syndrome, as a problem when chewing or swallowing, pointed out 4% of patients. Difficulties in biting or chewing revealed 10% of patients. As much as 87% stated they regularly visit a dentist, min. one time a year. Regarding self-oral care 15% of patients answered, they brush teeth only once a day. Most of the patients (51%) used manual toothbrush vs electrical – which can be more convenient for patients with problems of the hands/wrists. Only 21% used mouth-rinsing liquid. Difficulties in performing home oral hygiene procedures were reported by 9% when brushing teeth, and by 17% using dental floss or interdental brushes. 11% of responders rated the status of their gingiva as poor. Gingival bleeding spontaneous or related to brushing was experienced by respectively 15% and 49% of patients. No patients stated knowledge of an association between oral health and RA. <h3>Conclusions:</h3> The oral care in RA patients, including self-care, seems to require improvement. Providing important information to the patients about the relationship between the oral/periodontal health and RA disease activity should raise the patient's awareness, which may improve the course of the RA disease. <h3>References</h3> [1]Choi IA, et al. Periodontitis is associated with rheumatoid arthritis: a study with longstanding rheumatoid arthritis patients in Korea. [2]Fuggle NR, et al. Hand to mouth: a systemic review and meta–analysis of the association between rheumatoid arthritis and periodontitis. <h3>Disclosure of Interest:</h3> None declared