The Impact of an Oral Hygiene Education Module on Inflammatory Factors in Patients with Active Systemic Lupus Erythematosus

Abstract

Background: In patients with active systemic lupus erythematosus (SLE), inflammatory markers such as erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) are often elevated. Increases in these inflammatory biomarkers have been linked to periodontal diseases. Objectives: This study aimed to investigate the impact of oral health education on inflammatory markers in patients with SLE. Methods: In this field trial study, 40 SLE patients with no dental plaque were assigned to the intervention and control groups by block randomization design. The intervention group was educated in a 20-minute session based on Bass’s method of tooth brushing. Before and 3 months after the intervention, the dental plaque, CRP, ESR, and double-stranded DNA (anti-dsDNA) levels were determined in the two groups. Data were analyzed with SPSS software using independent t-test, Wilcoxon, Mann-Whitney, and univariate covariance analysis at 0.05 significance level. Results: In terms of basic variables, there was no significant difference between the two groups. O’Leary’s plaque index in the intervention group showed a significant decrease over time, but no significant reduction was observed in the control group. The difference between the two groups was statistically significant (P < 0.001). The results of covariance analysis and controlling for the effect on patients' performance showed that the health education intervention had a significant impact on ESR (effect size = 9.6%). However, the intervention had a slight effect on CRP, dsDNA, and SLE Disease Activity Index (SLE-DAI). Moreover, CRP, ESR, and dsDNA showed a significant decrease in both groups after the intervention; however, the difference was not significant. Conclusions: According to the results of the study, it is recommended to implement educational programs in the field of oral and dental hygiene and the correct way of brushing teeth for patients with SLE.