Identifying and treating periodontitis in patients with rheumatoid arthritis

Rheumatoid arthritis (RA) and periodontitis (PD) are chronic, inflammatory diseases causing tissue destruction with an epidemiologic link. PD may be directly involved in RA pathogenesis by facilitating peptide citrullination. Porphyromonas gingivalis, an oral pathogen in PD, expresses peptidylarginine deiminase that catalyzes protein citrullination. Small, single-center studies have shown improvements in RA measures with PD treatment, but this needs confirming by larger, well-designed investigations. Self-report surveys have recently been developed as an initial screening tool before subjecting patients to a resource-intensive full-mouth periodontal examination. In this report, we review the epidemiologic data linking PD with RA risk and progression, studies suggesting that PD may serve as a target for RA treatment, and briefly summarize methods that might be used for PD case finding.