Division of Obstetrics and Gynecology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan.
PLoS One. 2020 Sep 18;15(9):e0239442. doi: 10.1371/journal.pone.0239442. eCollection 2020.
Although it is known that patients with primary Sjögren's syndrome (pSS) have impaired dental conditions, incidence rates and incidence rate ratios of various dental diseases in these patients are not clear. The aim of this study was to investigate the frequency and prevalence of dental diseases in patients with pSS, and to evaluate the risk of common dental diseases in these patients.
A population-based retrospective cohort study was conducted using the data from the Taiwan's National Health Insurance Research Database. A total of 709 patients with newly diagnosed pSS between 2000 and 2012 were identified to form the pSS cohort. A comparison cohort of patients without pSS was assembled based on frequency matching for sex, 5-year age interval, and index year at a ratio of 10:1. All participants were followed until the end of the follow-up period or when the outcome of interest occurred. The incidence of dental caries, pulpitis, gingivitis, periodontitis, oral ulceration, and stomatitis were calculated using multiple Poisson regression models.
A significantly higher prevalence (74.6% vs. 63.0%, P = 0.001) and frequency (median 5.37 vs. 1.45 per year, P < 0.001) dental visits were observed in patients with pSS compared with patients in the comparison cohort. The risk of dental caries (adjusted incidence rate ratio [aIRR] 1.64, P < 0.001), pulpitis (aIRR 1.42, P < 0.001), gingivitis (aIRR 1.43, P < 0.001), periodontitis (aIRR 1.44, P < 0.001), oral ulceration (aIRR 1.98, P < 0.001), and stomatitis (aIRR 2.06, P < 0.001) were significantly higher in patients with pSS.
In this nationwide, population-based cohort study, a higher prevalence and frequency of dental visits were found in patients with pSS. Patients with PSS had increased risk of six most common dental disorders, including dental caries, pulpitis, gingivitis, periodontitis, oral ulceration, and stomatitis. Rheumatologists should remain vigilant for the dental health of patients with pSS.
虽然已知原发性干燥综合征（pSS）患者的口腔状况受损，但这些患者各种口腔疾病的发病率和发病率比值尚不清楚。本研究旨在调查 pSS 患者口腔疾病的发生频率和流行情况，并评估这些患者常见口腔疾病的风险。
本研究采用台湾全民健康保险研究数据库中的数据，进行了一项基于人群的回顾性队列研究。共确定了 2000 年至 2012 年间 709 例新诊断的 pSS 患者作为 pSS 队列。根据性别、5 岁年龄间隔和指数年，按照 10:1 的比例为每位患者匹配了 10 例无 pSS 的患者组成对照组。所有参与者均随访至随访期结束或发生感兴趣的结局。采用多泊松回归模型计算龋齿、牙髓炎、牙龈炎、牙周炎、口腔溃疡和口炎的发生率。
与对照组相比，pSS 患者口腔就诊的比例（74.6%比 63.0%，P = 0.001）和频率（中位数每年 5.37 次比 1.45 次，P < 0.001）均显著更高。pSS 患者的龋齿（调整发病率比 [aIRR] 1.64，P < 0.001）、牙髓炎（aIRR 1.42，P < 0.001）、牙龈炎（aIRR 1.43，P < 0.001）、牙周炎（aIRR 1.44，P < 0.001）、口腔溃疡（aIRR 1.98，P < 0.001）和口炎（aIRR 2.06，P < 0.001）的风险显著更高。
在这项全国性、基于人群的队列研究中，我们发现 pSS 患者口腔就诊的比例和频率更高。pSS 患者发生六种最常见口腔疾病（龋齿、牙髓炎、牙龈炎、牙周炎、口腔溃疡和口炎）的风险增加。风湿科医生应警惕 pSS 患者的口腔健康。
