Table 6 Evidence on other diseases and caries

Human studies on other diseases and caries

 Rheumatoid arthritis

  Ayräväinen et al

 [82]

Evaluate if oral inflammatory conditions are associated with RA and if targeted treatment of RA impacts oral health by comparing three groups-early untreated RA, chronic RA and controls

Case-control

124 (81 cases and 43 controls)

Finland

Outcomes: Patients in early untreated RA (EURA) group, bronchial asthma was significantly more common compared to other groups (p = 0.04); during the study, significant decrease in pain in joints in both RA groups (p < 0.001) and significant increase in patients who brushed twice a day (p = 0.04) occurred; DMFT and DMFS was non-significantly different between groups and total dental index (TDI) was significantly worse in RA patients compared to controls (p = 0.04); number of 4–5 mm pockets were significantly higher in EURA group vs. chronic RA patients at both baseline and follow up visits (p < 0.001); positive Rheumatoid factor (RF) was associated with oral inflammation and patients with positive RF had higher median TDI values and deep pockets (≥4mm) compared to patients with negative RF (p = 0.001 and p > 0.001 respectively); DMFT, DMFS, TDI indices and serologic markers (SSA/SSB and RNP antibodies) were significantly higher in EURA patients compared to other groups (p = 0.039); DMFT and DMFS was associated with disease activity score (DAS28) in both RA patient groups at baseline and follow up; DMFS had an increasing association with activity of RA (p < 0.001)

Conclusion: RA patients had poorer oral health compared to controls and caries indices were associated with RA activity

  Martinez-Martinez et al

 [83]

Evaluate frequency and severity of dental caries and the counts of cariogenic bacteria in RA patients when compared to controls

Case-control

160 (80 cases and controls)

Mexico

Outcomes: RA patients reported significantly higher dry mouth sensation compared to control group (p < 0.05); RA group had significantly higher decayed teeth (p = 0.0149) and lower count of FT (p = 0.0004) compared to control group; treatment needs index and care index were significantly higher in RA and control groups respectively (p = 0.0002 and p = 0.0009 respectively); S. mutans was significantly higher in RA patients compared to controls (p < 0.05)

Conclusion: Dental caries is more frequent and severe in RA patients

 Systemic lupus erythematosus (SLE)

  Loyola Rodriguez et al

 [84]

Compare the prevalence of dental caries in active and inactive SLE patients by evaluating clinical, salivary and bacterial factors

Case-control

60 (30 cases and controls)

Mexico

Outcomes: DMFT index was significantly higher in active SLE group when compared to inactive SLE group (p < 0.05) and only decayed component of DMFT index showed significant difference; functional teeth index (FS-T), treatment needs index (TNI) and care index (CI) were significantly different between groups (p < 0.05); integrative dental caries index (IDCI) showed significantly higher caries severity in the active SLE group for mild and moderate degrees of caries severity (p < 0.05); salivary flow and pH were significantly reduced in the active SLE group compared to inactive group (p < 0.05); DNA copies of S. mutans and S. sobrinus were significantly different between groups (p < 0.05); correlation was noted between SLE disease activity and DMFT, caries surfaces, pH, salivary flow, S. mutans and S. sobrinus and total bacteria (p < 0.0001)

Conclusion: SLE patients had high DMFT and active SLE patients had significantly high smooth surface caries along with high counts of S. mutans and S.sobrinus. A positive correlation was noted between active SLE and dental caries

  Gofur et al.  [85]

Compare dental caries burden in patients with increasing severity of SLE. DMFT, oral hygiene metrics [oral hygiene index-simplified (OHI-S), debris index (DI), plaque index (PI), calculus index (CI) and personal hygiene performance-modified index (PHP-M)] and SLE severity (SLE disease severity index) were collected

Cross sectional

93

Indonesia

Outcomes: Patients were divided into mild, moderate and severe SLE disease severity. 74% patients with SLE had dental caries. PHP-M (p < 0.001), PI (p = 0.001), OHI-S (p < 0.001), DMFT (p = 0.001) were significantly associated with SLE severity

Conclusion: Correlation between oral hygiene metrics, dental caries and SLE severity was found in SLE patients

 Chronic kidney disease

  Menezes et al

 [86]

Evaluate the association between chronic kidney disease and dental caries by comparing dental caries, salivary factors and cariogenic bacteria between patients with end stage renal disease and matched controls

Case-control

214 (107 cases and controls)

Brazil

Outcomes: Significantly higher CFUs of S. mutans (p = 0.02), amounts of anti-mutans IgA (p = 0.04), urea in saliva (p < 0.001) and significantly fewer FT (p < 0.001) in group with end stage renal disease; presence of S. mutans, lower DMFT, fewer FT, lower salivary calcium and higher salivary urea were associated with end stage renal disease; positive correlation between quantity of anti-streptococcus IgA antibodies, salivary urea, colony forming units (CFUs) of S. mutans and duration of hemodialysis were noted; negative correlation was noted between hemodialysis and FT

Conclusion: Programs to prevent and treat oral problems in end-stage renal disease patients on hemodialysis may be required to improve awareness and oral health condition