None listed
Conditions
Brief summary
To study the relationship between periodontal disease and rheumatoid arthritis and determine whether periodontal treatment reduces the clinical and biochemical symptoms of rheumatoid arthritis. Hypothesis: Reduction of periodontal inflammation in patients with chronic rheumatoid arthritis will reduce the clinical symptoms of rheumatoid arthritis Aim: Determine, in a prospective study, whether periodontal treatment has any bearing on clinical parameters of existing chronic rheumatoid arthritis.
Interventions
For patients in the treatment group we will undertake a course of conventional periodontal examination and treatment This will include oral hygiene instruction and full mouth cleaning over a 4 week period. These visits (30 minutes weekly for 4 weeks) will involve cleaning around the teeth under local anaesthesia, doing a quarter of the mouth at a time (upper right, upper left, lower left, lower right). Following this, regular periodontal maintenance involving a periodontal assessment, oral hygi
For patients in the treatment group we will undertake a course of conventional periodontal examination and treatment This will include oral hygiene instruction and full mouth cleaning over a 4 week period. These visits (30 minutes weekly for 4 weeks) will involve cleaning around the teeth under local anaesthesia, doing a quarter of the mouth at a time (upper right, upper left, lower left, lower right). Following this, regular periodontal maintenance involving a periodontal assessment, oral hygiene instruction and full mouth cleaning will be carried out 2,4 and 6 months after completion of the initial conservative periodontal treatment.
Sponsors
University of Adelaide
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
30 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
All participants must have rheumatoid arthritis. Willingness to participate and return for multiple visits; presence of gingivitis, mild, moderate or advanced chronic periodontitis, partially or fully dentate patients (at least 20 teeth); no evidence of known systemic modifiers of periodontal disease such as: type I and II diabetes mellitus, osteoporosis, disorders of cellular immunity (e.g. AIDS, cyclic neutropenia, or other known specific leukocyte defects which we know predisposes to periodontitis), medications known to influence the periodontal tissues, or any conditions that would contraindicate a periodontal examination (e.g. risk of bacterial endocarditis). To be included in the RA group, all participants must have rheumatoid arthritis. Patients will need to indicate a willingness to participate and return for multiple visits and be partially or fully dentate patients (at least 20 teeth). Individuals with evidence of sicca symptoms will not be excluded because decreased salivary flow in these individuals is NOT a modifying or predisposing factor for the development or progression of periodontitis. RA patients will need to have low to moderate disease activity (DAS 2.6-5.1)
Exclusion criteria
Patients who will not give informed consent; aggressive periodontitis, obvious endodontic infections or other sources of oral infection, pregnancy or lactating females; patients with a significant medical history indicating evidence of known systemic modifiers of periodontal disease as described above; patients who have taken prescribed systemic antibiotics in the last 3 months; patients who would need prophylactic antibiotics before any medical/dental procedures; patients who have received previous periodontal therapy. Smokers and individuals taking medications known to impact on gingival health will also be excluded as these individuals may have impaired responses to conservative periodontal therapy
Outcome results
None listed