An observation on the severity of periodontal disease in past cigarette smokers suffering from rheumatoid arthritis- evidence for a long-term effect of cigarette smoke exposure?

• Main Authors: Antal, M. (Author), Battancs, E. (Author), Bocskai, M. (Author), Braunitzer, G. (Author), Kovács, L. (Author)
• Format: Article
• Language: English
• Published: BioMed Central Ltd. 2018
• Subjects: Arthritis, Rheumatoid; case control study; Case-Control Studies; Chronic inflammation; complication; female; Female; human; Humans; Late sequelae; male; Male; middle aged; Middle Aged; periodontal disease; Periodontal disease; Periodontal Diseases; regression analysis; Regression Analysis; rheumatoid arthritis; Rheumatoid arthritis; risk factor; Risk Factors; severity of illness index; Severity of Illness Index; smoking; Smoking; time factor; Time Factors; Tobacco smoking
• Online Access: View Fulltext in Publisher

 Background: Rheumatoid arthritis (RA) and cigarette smoking are both risk factors for periodontal disease (PD). Previous research suggests that systemic inflammatory conditions and cigarette smoking may act in synergy, and their co-occurrence leads to a much higher risk of developing severe stage PD than what the combination of their individual risks would suggest. We originally sought to test this in the case of RA, but it turned out that the majority of our patients were former smokers, who smoked for prolonged periods in the past. For that reason, we decided to shift our focus toward the possible effects of past chronic cigarette smoke exposure. Methods: The data of 73 RA patients and 77 healthy controls were analyzed. The participants received a full-mouth periodontal examination to determine their periodontal status. Rheumatological indices and data on past tobacco use were also recorded. Both the patient and the control groups were divided into former smoker and non-smoker subgroups for the analyses. Non-smoker controls were used as the reference group. Results: In the control group, smoking in history increased the odds of developing both the moderate and the severe stages of PD, but the change was not statistically significant. RA significantly, increased the odds of developing both stages in itself, but the highest odds were seen in the former smoker RA group. Conclusion: Based on this surprising observation of ours, we hypothesize that chronic cigarette smoke might bring about permanent changes in the periodontal tissues, leading to their hypersensitivity to inflammatory challenges. © 2018 The Author(s).