Abstract
BACKGROUND: The presence of oral symptoms and signs in many systemic diseases is not uncommon knowledge. Investigations that explore the relationship between systemic diseases and their oral manifestations are of particular interest to dentists, as this enables them to be better clinicians with an acumen to recognize, treat, or refer patients with the systemic disease to general physicians. This study was undertaken to understand the oral manifestations of systemic lupus erythematosus (SLE) with an emphasis on oral mucosal lesions, dental caries, and periodontitis. METHODS: A single institutional cross-sectional survey was conducted from September 2017 to July 2018 on a sample of 500 SLE patients attending the Institute of Rheumatology, Rajiv Gandhi Government General Hospital, Chennai. The dentition status, periodontal status, and oral mucosal lesions were assessed by a single trained and calibrated examiner using the World Health Organization (WHO) proforma, 2013. Besides, disease activity in SLE patients was assessed by rheumatologists using the SLEDAI index with a cutoff score of more than 4 indicating the presence of active disease. Demographic characteristics including age, gender, occupation, monthly income, and education status were assessed using a questionnaire. Data were entered into an Excel Sheet and all statistical analyses were performed using SPSS for Windows version 20.0 (SPSS Inc., Chicago, IL, USA). RESULTS: In the present study, the prevalence of dental caries was found to be 87.6% in patients with SLE. The prevalence of severe periodontitis defined as the presence of at least one tooth with a 6 mm or deeper pocket was found to be 85% and the prevalence of oral mucosal lesions was found to be 86%. The prevalence percentage for dental caries, periodontal disease, and oral mucosal lesions were found to be higher than the rates reported for the general population in India. Patients with active SLE had a higher prevalence of dental caries, periodontitis, and oral mucosal lesions than patients with inactive SLE. CONCLUSION: It can be concluded from the present study that SLE patients are more vulnerable to oral diseases than the general population. Furthermore, disease activity in SLE patients has a strong positive correlation with oral health status in SLE patients.