The following excerpt and reference was found on the web site from the Spondylitis Association of America. New members: also note the several lengthy topics we posted in the last few years about the importance of maintaining good dental health (use the search utility) or see the FAQs for a consolidated topic.
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Ankylosing Spondylitis and Gum (Periodontal) Disease
A study published in the January 2009 issue of the Annals of Rheumatic Diseases examined ankylosing spondylitis patient's risk of periodontal (gum) disease. Perio.org describes periodontitis as follows: "Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed."
The study concludes that "AS patients have a significantly higher risk of PD [periodontal disease],
strongly suggesting the need of a close collaboration between rheumatologists, periodontists and dental hygienists when treating AS patients."
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Periodontal disease in patients with ankylosing spondylitis
Nicole Pischon 1*, Tobias Pischon 2, Ensar Gülmez 1, Jörn Kröger 1, Peter Purucker 1, Bernd-Michael Kleber 1, Helga Landau 3, Paul-Georg Jost-Brinkmann 3, Peter Schlattmann 4, Jan Zernicke 5, Gerd Burmester 5, Jean-Pierre Bernimoulin 1, Frank Buttgereit 5 and Jacqueline Detert 5
1 Dept. of Periodontology, Universitätsmedizin Charité, Germany
2 Dept. of Epidemiology, German Institute of Nutrition (DIFE), Germany
3 Dept. of Orthodontics, Universitätsmedizin Charité, Germany
4 Dept. of Biometry, Universitätsmedizin Charité, Germany
5 Dept. of Rheumatology, Universitätsmedizin Charité, Germany
Objective: Ankylosing spondylitis (AS) and periodontal disease (PD) are characterized by dysregulation of the host inflammatory response, resulting in soft and hard connective tissue destruction. AS has been related to other inflammatory diseases, however, there is a paucity of data on whether AS is associated with inflammatory PD.
Methods: The association between AS and PD was examined in 48 patients with AS and 48 healthy controls, matched on age and gender. AS was diagnosed according to the modified New York criteria. Periodontal examination included probing pocket depth (PPD), clinical attachment loss (CAL), plaque index (PI) and bleeding on probing (BOP). Potential risk factors of PD such as smoking, low education, alcohol consumption, Body Mass Index (BMI), as well as chronic diseases associated with PD and AS were assessed through questionnaires.
Results: In stepwise logistic regression, including AS status, age, gender, education, smoking, alcohol consumption, and BMI, only AS status, age, and education remained significant predictors of PD. Patients with AS had a significantly 6.81-fold increased odds (95 %-CI 1.96-23.67) of PD (defined as mean attachment loss > 3 mm) compared to controls. The strength of the association was attenuated but remained statistically significant after further adjustment for plaque accumulation (odds ratio 5.48; 95 %-CI 1.37-22.00).
Conclusion: The present study shows that AS patients have a significantly higher risk of PD, strongly suggesting the need of a close collaboration between rheumatologists, periodontists and dental hygienists when treating AS patients.