Studies observing a stark and compelling correlation between periodontitis and dental bone loss in individuals suffering from psoriasis—an autoimmune disorder characterized by thick, red, itchy, scaly skin plaques—are not new. As early as 2013, Scandinavian researchers, working with a wealth of data from the groundbreaking US-based retrospective longitudinal Nurses’ Health Study, noted and remarked on an unusual correlation between the incidence of psoriasis and periodontal bone loss.
Now German researchers have built on and refined that data, isolating particular gene expressions that may be responsible for both the inflammatory mechanisms of psoriatic plaques, bone resorption, and periodontitis—a deep dive into the causes of psoriasis and its associated symptoms that may potentially serve as a boon to researchers seeking pharmacological and even genetic interventions into the disorder.
Researchers enrolled 100 patients with psoriasis and 101 without psoriasis in a study and evaluated the oral health of each. The group of patients with psoriasis had significantly poorer oral health than the control group of patients without psoriasis. To date, the new study’s authors note, relatively few other studies have sought to establish firm links between the conditions, but those studies which have been performed confirm this rich vein of inquiry.
A 2014 Scandinavian study also looked at a group of fifty patients with psoriasis and a control group of 121 patients without psoriasis. This study found the group of patients with psoriasis had significantly higher rates of moderate and severe periodontitis (24 percent) compared with the control group of patients without psoriasis (10 percent). In addition, this study found 36 percent of patients with psoriasis demonstrated 3 mm or greater radiographic bone loss at one or more sites, versus just 13 percent of control patients without psoriasis.
These studies suggest additional vigilance is in order for dentists and physicians helping patients to manage psoriasis as well as their oral health. This is especially true in the United States as patients here are flooded with direct-to-consumer advertising for biologic and pharmaceutical medications to manage plaque psoriasis. The potential for periodontal consequences, oral bone loss, and eventual tooth loss among this population are real and serious, and it calls for an interdisciplinary approach as we continue pursuing genetic answers.