Association of Oral Health with Risk of Rheumatoid Arthritis: A Nationwide Cohort Study

Yoonkyung Chang, Min Kyung Chung, Jung Hyun Park, Tae Jin Song

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Periodontitis and rheumatoid arthritis (RA) are inflammatory diseases that share many similarities. We aimed to investigate the associations of periodontitis and oral hygiene status and behaviors with RA in a nationwide general population cohort. Participants from the National Health Screening cohort database of Korea who underwent oral health screening by dentists between 2003 and 2004 were included. The occurrence of RA was analyzed according to the presence of periodontitis, oral health examination findings, and behaviors. Overall, 2,239,586 participants were included. During a median of 16.7 years, RA occurred in 27,029 (1.2%) participants. The risk for incident RA was higher when participants had periodontitis (hazard ratio (HR) 1.2, 95% confidence interval (CI), 1.08−1.24) and an increased number of missing teeth (HR 1.5, 95% CI, 1.38−1.69). In contrast, better oral hygiene behaviors, such as a higher frequency of daily tooth brushing (HR 0.76, 95% CI 0.73–0.79, p for trend <0.001) and a recent history of dental scaling (HR 0.96, 95% CI 0.94–0.99), were associated with a lower occurrence of RA. Periodontitis and increased missing teeth were associated with an increased risk of RA. Maintaining good oral hygiene through frequent tooth brushing and regular dental scaling may reduce the risk of RA occurrence.

Original languageEnglish
Article number340
JournalJournal of Personalized Medicine
Issue number2
StatePublished - Feb 2023

Bibliographical note

Funding Information:
This work was supported by an Institute of Information & Communications Technology Planning & Evaluation (IITP) grant funded by the Korea government (MSIT) (No. 2022-0-00621 to T.-J.S., Development of artificial intelligence technology that provides dialog-based multi-modal explainability), a grant of the Korea Health Technology R & D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Wel-fare, Republic of Korea (grant number: HI22C073600 to T.-J.S.), and a grant from the Basic Science Research Program through the National Research Foundation of Korea, funded by the Ministry of Education (2021R1I1A1A01059868 to Y.C.).

Publisher Copyright:
© 2023 by the authors.


  • dental scaling
  • oral hygiene
  • periodontitis
  • rheumatoid arthritis toothbrushing


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