Salivary periodontal pathogens in patients with rheumatoid arthritis and periodontitis: correlations with disease activity

This study aims to analyze and compare salivary periodontal pathogens in patients with concomitant periodontitis (CP) and rheumatoid arthritis (RA) versus those with CP alone. A total of 62 patients with CP + RA, 29 patients with CP alone, and 24 healthy controls were included. Periodontal parameters, including sulcus bleeding index (SBI), periodontal pocket probing depth (PPD), and clinical attachment loss (CAL), as well as RA-related indices, erythrocyte sedimentation rate, C-reactive protein, anti-cyclic citrullinated peptide antibody (anti-CCP), and rheumatoid factor (RF), were assessed. The detection rates and DNA loads of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Tannerella forsythia, and Prevotella intermedia were quantified by PCR. The detection rates of P. gingivalis and T. forsythia, together with the DNA loads of P. gingivalis, T. forsythia, and P. intermedia, were significantly higher in the CP + RA group than in the CP group (P < 0.05). Both PPD and CAL showed strong positive correlations with anti-CCP levels (r = 0.849 and 0.758, respectively; P < 0.001). Patients with concurrent CP and RA demonstrated increased salivary loads of specific periodontal pathogens. Moreover, the extent of periodontal tissue destruction, as indicated by CAL and PPD, was positively associated with RA autoimmune activity, reflected by anti-CCP levels, suggesting a potential pathogenic link between periodontitis and rheumatoid arthritis.