Background: Patients with rheumatic diseases exhibit an increased risk of oral problems. Despite its relevance, this issue is often overlooked in rheumatology. The CPOD index (stands for Carious, Periodontal, Oral, and Dental) is used to quantify dental health by evaluating the number of decayed, missing, and filled teeth, while other tools like GOHAI (Geriatric Oral Health Assessment Index) evaluates the perception of oral health-related quality of life. Assessing oral health using these tools is crucial to identify unmet dental care needs and improve the overall quality of life in patients with rheumatic diseases.

Objectives: We aimed to compare the prevalence of oral health problems and the self-perception of oral health in patients with rheumatic diseases.

Methods: We conducted a cross-sectional study at the rheumatology clinic of the University Hospital ‘Dr. José Eleuterio González’. Adult patients with a rheumatic disease diagnosis were included. Patients underwent a comprehensive dental evaluation performed by a qualified dentist. The presence of cavities, missing, and/or filled teeth was assessed using the CPOD index. The International Caries Detection and Assessment System (ICDAS) index assessed dental caries in all 32, which ranges from 0 (healthy tooth surface with no caries) to 6 (extensive cavitation involving more than half the tooth structure). The GOHAI score was used to evaluate patients’ oral health perception, where higher scores reflect better oral health perception, with a maximum possible score of 60. Patients were classified into two groups based on their GOHAI scores: a score of <45, indicating poor oral health perception, and a score of ≥45, indicating good oral health perception. Comparisons between groups were performed using Chi-squared, Student’s T, or the Mann-Whitney U test, as appropriate. A p-value <0.05 was considered statistically significant.

Results: We included 324 patients: 297 (84.6%) women and 27 (7.6%) men, with a median age of 53 (IQR 43–64) years. Most patients had rheumatoid arthritis (48.1%) or systemic lupus erythematosus (14.7%). The mean CPOD index was 12.5 ± 5.8 and the median GOHAI score was 50 (IQR 44–53). Of the patients, 103 (31.7%) had a GOHAI score <45, indicating poor oral health perception, while 222 (68.5%) had a score ≥45, indicating good oral health perception. Alcohol consumption was higher in patients with a good oral health than those with poor oral health perception (16.6% vs. 6.7%, p = 0.01). Patients with good oral health had a similar CPOD index (12.1 ± 5.3) than poor oral health perception patients (13.1 ± 6.6, p= 0.23), although numerically lower. Also, the proportion of patients with >3 decayed teeth was higher among those with poor oral health than in those with good oral health perception (41.7% vs. 27.9%, p = 0.01). Additionally, patients with poor oral health perception presented >3 filled teeth than their counterparts (35.9 vs. 25.2, p= 0.05). Complete results are shown in Table 1. One-hundred and eighty-nine patients had ICDAS index assessed, their median GOHAI score was 48 (IQR 42–52). The majority of the patients with ICDAS scores 1-3 (33%) had between 5 and 10 affected teeth, while the majority with ICDAS scores 4-6 (79.1%) had fewer than 5 affected teeth.

Conclusion: We found that patients with rheumatic diseases exhibit a high burden of dental issues, as evidenced by CPOD and ICDAS index. The frequency of decayed, missing, and filled teeth was more pronounced in those with poorer perceptions of oral health. These findings highlight the importance of addressing the oral health needs of patients with rheumatic diseases.

REFERENCES: [1] Alvarez-Azaustre MP, Greco R, Llena C. Oral-health-related quality of life as measured with the Child-OIDP index and oral health status in Spanish adolescents. Int J Environ Res Public Health . 2022;19(19):12450. doi:10.3390/ijerph191912450.

[2] Mehdipour A, Masoumi M, Shajari P, Aghaali M, Mousavi H, Saleh A, Ansarian M. Oral health-related quality of life and dental caries in rheumatoid arthritis patients: a cross-sectional observational study. Int J Environ Res Public Health . 2022;19(19):12450. doi:10.3390/ijerph191912450.

Acknowledgements: NIL.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.