Periodontitis Risk in Patients With and Without Systemic Lupus Erythematosus: A Retrospective Study

Objectives: Systemic lupus erythematosus is a systemic, long-term autoimmune condition that has chronic inflammatory effects in connective tissue throughout the body. There are numerous studies that have examined the association between systemic lupus erythematosus and chronic periodontitis, with varying conclusions. The purpose of this cross-sectional study is to evaluate and compare the risk for periodontitis in patients with SLE to patients without SLE. Materials and Methods: Medical and dental records were retrospectively reviewed for patients that had been admitted to the Temple University School of Dentistry from 2010 to 2018. A roster of 22 SLE positive patients were generated from the Temple University patient database and matched to a control population of 22 patients without SLE. Periodontal probing depths were then documented and used to evaluate periodontal statuses in both test and control groups. Sites with probing depths ≥ 5 mm were considered to be at increased risk for periodontal breakdown. Prevalence was defined as the percentage of individuals having at least one site with a ≥ 5 mm probing depth, and extent was defined as the average percentage of sites with increased periodontitis risk. The number of missing teeth in patients from each group were also recorded as a secondary outcome. Results: The prevalence of ≥ 5 mm probing depths in SLE and control groups was 50 % (10/20) and 40.9 % (9/22), respectively. Calculations of relative risk (1.22) and odds ratio (1.44) were not statistically significant between the two populations (p > 0.05). The extent of ≥ 5 mm probing depths was 1.5 % in SLE patients and 3.7 % in healthy patients, which was also not significant between groups (p > 0.05). SLE patients were missing an average of 9.6 teeth per individual compared to 3.8 in healthy patients (p < 0.05). Conclusions: The results of the present study indicate that patients with SLE do not have an increased risk for periodontitis when compared to patients without SLE. Risk analysis on the prevalence and the extent of deeper probing depths were not statistically different between SLE and control groups. Further studies with a larger sample size and elimination of unseen confounders are needed in order to validate our results. An interesting observation was the finding that SLE patients have a significantly greater number of missing teeth. The exact mechanism through which SLE patients experience periodontal breakdown and increased tooth loss is an avenue that warrants future research. Keywords: systemic lupus erythematosus (SLE); chronic periodontitis Abbreviations: SLE: Systemic Lupus Erythematosus, CP: Chronic Periodontitis, SLEDAI: Systemic Lupus Erythematosus Disease Activity Index, BOP: Bleeding on Probing, CAL: Clinical Attachment Level.