Oral health in patients with severe inflammatory dermatologic and rheumatologic disease

BACKGROUND: Poor oral health (OH) is a risk factor for systemic disease and lower quality of life (QoL). Patients with inflammatory dermatologic/rheumatologic diseases report more oral discomfort, dry mouth, and periodontal disease than controls. Medications used to treat these conditions can also adversely affect OH. OBJECTIVES: The aim was to assess the OH of patients with chronic inflammatory dermatologic/rheumatologic diseases treated with systemic/biologic therapy, compared to controls. METHODS: Patients with chronic inflammatory dermatologic/rheumatologic diseases treated with systemic/biologic therapy were recruited from outpatient clinics across two university hospitals. All patients had a standardized World Health Organisation OH assessment performed consisting of an OH exam and questionnaire. Age‐ and sex‐matched controls without chronic inflammatory disease were recruited from a pigmented lesion clinic. Charts of patients with chronic inflammatory dermatologic/rheumatologic diseases were reviewed to assess OH documentation. RESULTS: One hundred patients were examined (50 cases and 50 controls). Patients with inflammatory dermatologic/rheumatologic diseases (cases) had poorer periodontal status (mean loss of attachment 6.9 mm vs. 1.9 mm controls, p = 0.01), more missing teeth (mean 7.7 vs. 4.4 controls, p = 0.029), more dry mouth (82% vs. 20% controls, p = 0.001), and less frequent tooth brushing (60% vs. 80% controls, p = 0.037). Of 250 patient charts which were reviewed, 98.4% (n = 246) had no documentation of OH. CONCLUSION: Patients with severe inflammatory dermatologic/rheumatologic conditions have poorer OH and OH‐related QoL. Clinicians should appreciate the risk of poor OH in this cohort and have a low threshold for involving OH professionals in care pathways for severe inflammatory disease.