The effects of inflammatory dermatological/rheumatological diseases on oral health

Objectives  There is increasing recognition of the impact poor oral health has on general health and quality of life. The literature suggests that patients with inflammatory dermatological/rheumatological disease report more oral discomfort/pain, levels of periodontal disease and dry mouth than healthy controls. The systemic medications used to treat these conditions can also adversely affect oral health. This study aims to assess the oral health status of patients with a chronic inflammatory dermatological/rheumatological diagnosis versus controls.  Methods  Patients with chronic inflammatory dermatological/rheumatological diseases requiring systemic therapy were recruited from dermatology/ rheumatology outpatient clinics in two university hospitals.  All patients had a standardized and validated WHO oral health assessment performed consisting of an oral health exam (DMFT, Periodontal Status , Oral Mucosal Lesions, Dentures and TMJ pain/dysfunction) and oral health questionnaire ( Oral Pain/Discomfort, Oral Hygiene Habits, Smoking, Alcohol, Education, Oral Health Related Quality of life measures (OHRQoL)). Patients with noninflammatory dermatological conditions were recruited as controls.  A chart review of patients with chronic inflammatory dermatological/rheumatological diseases was also conducted to ascertain if any mention of Oral Health in chart.  Results  100 patients were examined (50 cases and 50 controls). Patients with an inflammatory dermatological/rheumatological diagnosis (cases) had statistically significant •Poorer periodontal status: mean cases 6.94 v 1.91 controls (P=0.01) •Greater number of missing teeth: mean cases 7.74 v 4.36 controls (P=0.029) •Reported worse dry mouth: 82% cases v 20% controls (P=0.001) •Reported less tooth brushing frequency: 42.9% cases v 57.1% controls (P= 0.037). 200 patient charts were reviewed. 98% (n=196) had NO mention of Oral Health. Conclusions  This study demonstrates that patients with inflammatory dermatological/rheumatological conditions have poorer oral health and oral health related quality of life. More involvement of dental health professionals in the prevention of dental diseases in this cohort of patients and the development of targeted interventions and pathways is required