Interdisciplinary Center of Rheumatic Diseases (INDIRA), University Hospital Tuebingen, Tuebingen, Germany.
Eberhard Karls University of Tuebingen, Tuebingen, Germany.
Rheumatol Int. 2024 Aug;44(8):1567-1573. doi: 10.1007/s00296-024-05635-z. Epub 2024 Jun 14.
In daily rheumatology practice, systemic sclerosis is primarily regarded as a potentially life-threatening disease characterized by fibrosis of various organs. Therefore, other manifestations, such as orofacial involvement, are often not of primary concern. Furthermore, due to its rarity, the disease might not be well known by dentists, which contrasts with the increased risk of various problems in the oral cavity. Periodontitis in particular is a known risk factor for morbidity and mortality and is associated with various systemic diseases. The risk of periodontitis appears to be increased in patients with systemic sclerosis, but little is known about the gender-specific differences. This study aims to elucidate the health-conscious behaviour of patients, their dental care and the risk of periodontitis with regard to gender-specific differences. This descriptive study of the Interdisciplinary Centre of Rheumatic Diseases (INDIRA) in collaboration with the Department of Orthodontics at the University Hospital of Tuebingen, Germany, examined the data of 148 patients with systemic sclerosis with regard to their oral health using a questionnaire and evaluating the risk of periodontitis with the DG Paro self-assessment score in this cohort. Among the participating patients, 90% reported regular visits to the dentist and good dental care. Nevertheless, more than half of the patients had missing teeth and problems opening their mouths. Sicca symptoms in the oral cavity were also common (40%). The risk of periodontitis among female participants was high (around 60%), and even higher among male study participants (around 80%). Gingival bleeding as a surrogate parameter for periodontitis was associated with salivary flow and the modified Rodnan skin score (mRSS). Despite a high awareness of dental health, we observed a high risk of periodontitis, especially in male patients with systemic sclerosis. In addition, the association between xerostomia and missing teeth as well as gingival bleeding and mRSS may indicate an increased risk in patients with a more progressive disease. We would therefore recommend regular dental consultations and careful oral hygiene for patients with systemic sclerosis in addition to the-more organ-focused-regular examinations of patients.
在日常的风湿病学实践中，系统性硬化症主要被视为一种潜在的危及生命的疾病，其特征是各种器官的纤维化。因此，口腔受累等其他表现通常不是首要关注点。此外，由于其罕见性，牙医可能对该病了解不多，这与口腔中各种问题的风险增加形成对比。牙周炎尤其被认为是发病率和死亡率的一个已知危险因素，并且与各种系统性疾病有关。系统性硬化症患者的牙周炎风险似乎增加，但关于性别特异性差异知之甚少。本研究旨在阐明患者的健康意识行为、口腔护理以及牙周炎的风险与性别特异性差异。这项由德国图宾根大学医院正畸科与风湿病学跨学科中心（INDIRA）合作进行的描述性研究，使用问卷检查了 148 名系统性硬化症患者的口腔健康，并使用 DG Paro 自我评估评分评估了该队列中牙周炎的风险。在参与的患者中，90%的人报告定期去看牙医并进行良好的口腔护理。尽管如此，超过一半的患者有缺牙和张口困难的问题。口腔干燥症状也很常见（40%）。女性参与者患牙周炎的风险较高（约 60%），男性参与者的风险更高（约 80%）。牙龈出血作为牙周炎的替代参数与唾液流量和改良 Rodnan 皮肤评分（mRSS）相关。尽管对口腔健康的认识很高，但我们观察到系统性硬化症男性患者的牙周炎风险很高。此外，口干症与缺牙以及牙龈出血和 mRSS 之间的关联可能表明疾病进展较快的患者风险增加。因此，我们建议除了对患者进行更关注器官的常规检查外，还应为系统性硬化症患者定期进行牙科咨询和仔细的口腔卫生。
