Beyond Systemic Burden: Periodontitis and Oral Health-Related Quality of Life in Psoriatic Disease

Abstract Beyond Systemic Burden: Periodontitis and Oral Health-Related Quality of Life in Psoriatic Disease Background : This cross-sectional study aimed to compare periodontal status and oral health-related quality of life (OHRQoL) among patients with psoriasis (PsO), psoriasis with psoriatic arthritis (PsO + PsA), and healthy controls, and to identify the independent contributions of periodontitis and psoriatic disease burden to OHRQoL. Methods : This cross-sectional study included 250 participants (130 controls, 60 PsO, 60 PsO + PsA). OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14). Periodontal status was evaluated by full-mouth clinical examination, and oral hygiene behaviors were recorded. Psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI), whereas PsO + PsA activity and enthesitis were evaluated using the Disease Activity Index for Psoriatic Arthritis (DAPSA) and the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES). Results : Total OHIP-14 scores differed significantly among groups (p < 0.001), with the PsO + PsA group showing the poorest OHRQoL, particularly in the psychological disability, social disability, and handicap domains. Bleeding on probing, DMFT, and tooth loss were greater in the PsO + PsA group, although periodontitis prevalence did not differ significantly among groups. In multivariable analysis, periodontitis (B = 5.629, 95% CI 4.015–7.243, p < 0.001), PsO + PsA (B = 2.880, p = 0.002), and PsO (B = 1.872, p = 0.034) were independently associated with poorer OHRQoL. Among patients with PsO + PsA, OHIP-14 scores correlated with disease duration (r = 0.409, p = 0.001), DAPSA (r = 0.433, p = 0.001), and MASES (r = 0.378, p = 0.003), but not with periodontal parameters. Conclusions : Periodontitis and psoriatic disease burden independently contribute to impaired OHRQoL in patients with psoriatic disease. Clinical Relevance : Integration of routine periodontal screening into the multidisciplinary management of psoriasis and psoriatic arthritis, coordinated among dermatologists, rheumatologists, and dental practitioners, may represent a clinically meaningful strategy to optimize patient-reported outcomes.