Periodontal Health Should Be Monitored Closely in Patients With Psoriasis

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dental cleaning
Patients with psoriasis reported significantly higher values for parameters that address periodontal inflammation.

In patients with psoriasis, regular periodontal checkups are recommended and periodontal treatment should be initiated as soon as possible whenever required.

Recognizing that available data on the periodontal and dental status of patients with psoriasis are scant, study investigators conducted a prospective study in which individuals with psoriasis were compared with controls, and the results of their analysis were published in the Journal of Investigative Dermatology.

A total of 100 patients with plaque psoriasis (mean age, 47.4±14.7; range, 19 to 79) who presented at the outpatient service of a specialized psoriasis center, department of dermatology, University Medical Center Schleswig-Holstein, Campus Kiel in Germany and 101 controls without psoriasis (mean age, 46.9±16.8; range, 18 to 86) were enrolled in the study. Standardized measures were utilized to evaluate oral health, including Bleeding on Probing (BOP), Community Periodontal Index (CPI), and dental parameters based on the DMFT-index (cumulative index: total of teeth registered as decayed [“D”], missing [“M”], and filled [“F”]).

A Psoriasis Area and Severity Index (PASI) <10 was observed in 96% of patients with psoriasis, with 4% reporting a PASI >10. No treatment was administered in 9% of patients with psoriasis, whereas 25% were receiving topical therapy and 66% were receiving systemic therapy (50% on biologic agents, 21.2% on methotrexate, 21.2% on fumaric acid esters, 4.5% on systemic combination therapy, and 1% on other systemic treatments).

A post-matching strategy was applied for analysis, with 53 pairs of patients with psoriasis and controls without psoriasis in whom relevant factors with a possible impact on oral health status were taken into account. Results of the study demonstrated that the matched group of patients with psoriasis had significantly higher BOP values (P <.011) and CPI (P <.002) values compared with matched controls. Per logistic regression analyses, significant correlations were identified in the psoriasis group with high BOP and CPI values, but not with missing teeth. Moreover, patients with psoriasis reported significantly higher values for parameters that address periodontal inflammation.

The investigators concluded that based on the findings from this study, patients with psoriasis should undergo regular dental checkups on periodontal status and should receive any required treatment where necessary.

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Woeste S, Graetz C, Gerdes S, Mrowietz U. Oral health in patients with psoriasis – a prospective study [published online January 2, 2019]. J Invest Dermatol. doi:10.1016/j.jid.2018.12.014