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Comparative Study
. 2025 Mar 18;25(1):399.
doi: 10.1186/s12903-025-05762-4.

Comparative study of the profile of supragingival dental plaque and tooth decay in patients with lupus erythematosus and rheumatoid arthritis

Aida Mehdipour  1 , Maryam Masoumi  2 , Roohollah Fateh  3 , Mohammad Aghaali  4 , Faezeh Mohammadidana  5 , Ali Saleh  5 , Alireza Rasouli  3 , Faezeh Kabiri  6
Affiliations
Comparative Study

Comparative study of the profile of supragingival dental plaque and tooth decay in patients with lupus erythematosus and rheumatoid arthritis

Aida Mehdipour et al. BMC Oral Health. .

Abstract

Background and objectives: Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are complex autoimmune diseases that present with a range of systemic and oral manifestations including dental decay and alterations in the oral microbiome profile. The purpose of this study was to compare the fungal and bacterial profile of supragingival dental plaque and dental caries in patients with SLE and RA.

Methods: The present descriptive-cross-sectional-analytical study was conducted on 91 participants (31 RA, 30 lupus, and 30 control groups). Decayed, Missing, and Filled teeth (DMFT) and The International Caries Detection Assessment System (ICDAS) indices were used to investigate tooth decay. The DAS-28 index was used to assess the severity of RA, and the SLEDAI-2 K index was used to evaluate the severity of lupus. The number of supragingival dental plaque Streptococcus mutans, Lactobacillus spp. and Candida albicans colonies were evaluated using Mitis Salivarius Agar (MSA), deMan-Rogosa-Sharpe agar (MRS) and Sabouraud Dextrose Agar with Chloramphenicol (SC) culture medium, respectively. Data were analyzed using one-way ANOVA, Kruskal -Wallis, k2, Fisher's tests, and Spearman's correlation coefficient.

Results: A statistically significant relationship was observed between the education level (P = 0.030), mean of DMFT, ICDAS, MSA and SC indices (P < 0.001) with the type of disease. The control and RA group showed significantly higher MRS index than the lupus group (P < 0.001). There was significant and positive correlation between the severity of the disease in lupus patients and SC (Candida albicans) (P < 0.001, R = 0.698) and MRS (P = 0/020, R = 0.408) indices.

Conclusion: Dental decay and the fungal and bacterial flora of supragingival dental plaque patients are higher than in the healthy group. It is recommended that these patients pay more attention to their oral hygiene and undergo periodic oral examinations.

Keywords: Candida albicans; Lactobacillus spp.; Streptococcus mutans; Lupus erythematosus; Rheumatoid arthritis; Tooth decay.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was performed according to the Helsinki Declaration guidelines after obtaining the approval of the Ethics Committee of Qom University of Medical Sciences (Code No. IR.MUQ.REC.1402.077). All methods were carried out in accordance with the relevant guidelines and regulations. The written informed consent of the participants was also obtained. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
2010 ACR/EULAR classification criteria for rheumatoid arthritis
Fig. 2
Fig. 2
2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus
Fig. 3
Fig. 3
Study design flowchart. RA: Rheumatoid arthritis, SLE: Systemic Lupus Erythematosus
Fig. 4
Fig. 4
Relationship between disease type and DMFT index. DMFT; (Decayed, Missing, and Filled teeth)
Fig. 5
Fig. 5
Relationship between disease type and MRS index. MRS; (deMan, Rogosa, and Sharpe)
Fig. 6
Fig. 6
Relationship between disease type and SC index. SC; (Sabouraud Dextrose Agar with Chloramphenicol)
Fig. 7
Fig. 7
Relationship between disease type and MSA index. MSA; (Mitis Salivarius Agar)
See this image and copyright information in PMC

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