Increased risk of developing dental diseases in patients with primary Sjogren's syndrome-A secondary cohort analysis of population-based claims data

Background Although it is known that patients with primary Sjogren's syndrome (pSS) have impaired dental conditions, incidence rates and incidence rate ratios of various dental diseases in these patients are not clear. The aim of this study was to investigate the frequency and prevalence of dental diseases in patients with pSS, and to evaluate the risk of common dental diseases in these patients. Methods A population-based retrospective cohort study was conducted using the data from the Taiwan's National Health Insurance Research Database. A total of 709 patients with newly diagnosed pSS between 2000 and 2012 were identified to form the pSS cohort. A comparison cohort of patients without pSS was assembled based on frequency matching for sex, 5-year age interval, and index year at a ratio of 10:1. All participants were followed until the end of the follow-up period or when the outcome of interest occurred. The incidence of dental caries, pulpitis, gingivitis, periodontitis, oral ulceration, and stomatitis were calculated using multiple Poisson regression models. Results A significantly higher prevalence (74.6% vs. 63.0%,P= 0.001) and frequency (median 5.37 vs. 1.45 per year,P< 0.001) dental visits were observed in patients with pSS compared with patients in the comparison cohort. The risk of dental caries (adjusted incidence rate ratio [aIRR] 1.64,P< 0.001), pulpitis (aIRR 1.42,P <0.001), gingivitis (aIRR 1.43,P< 0.001), periodontitis (aIRR 1.44,P< 0.001), oral ulceration (aIRR 1.98,P <0.001), and stomatitis (aIRR 2.06,P< 0.001) were significantly higher in patients with pSS. Conclusions In this nationwide, population-based cohort study, a higher prevalence and frequency of dental visits were found in patients with pSS. Patients with PSS had increased risk of six most common dental disorders, including dental caries, pulpitis, gingivitis, periodontitis, oral ulceration, and stomatitis. Rheumatologists should remain vigilant for the dental health of patients with pSS.