Changes In Oral Health In Patients With Behcet’s Disease: 10-Year Follow Up (original) (raw)
Related papers
Journal of Oral Pathology & Medicine, 2009
Objective: The aim of the study was to evaluate the influence of dental and periodontal treatments to the course of oral ulcers in patients with Behcet’s disease (BD).Methods: Fifty-eight consecutive BD patients with oral ulcers were studied. Twenty-nine patients were in the intervention group (F/M: 15/14, mean age: 39.6 ± 6.9 years) and 29 (F/M: 15/14, 39.4 ± 10.6 years) were followed with a conventional treatment approach. In addition to oral hygiene education, dental and periodontal treatments were carried out in the intervention group, whereas the control group was only given oral hygiene education. Patients were evaluated in the pre-treatment observation period (1 month), treatment period (1 month) and 6 months after treatment.Results: An increase in the number of new oral ulcers (4.1 ± 3.5) was observed within 2 days during the treatment compared with 3–30 days during treatment month (2.3 ± 1.2) (P = 0.002). However, 6 months after the treatment, the number of oral ulcers (1.9 ± 1.5) was significantly lower compared with the pre-treatment observation (4.8 ± 3.2) (P = 0.000) and treatment periods (6.4 ± 2.3) in the intervention group (P = 0.05), whereas a similar oral ulcer presence was observed in the control group (2.8 ± 2.4, 3.7 ± 2.3 and 4.8 ± 4.3, respectively) (P > 0.05). Dental and periodontal indices were also better in the intervention group during the 6-month follow-up.Conclusion: Our results suggest that, in BD patients, dental and periodontal therapies could be associated with a flare-up of oral ulcers in the short term, but may decrease their number in longer follow-up. They also lead to a better oral health.
Unmet need in Behcet’s disease: most patients in routine follow-up continue to have oral ulcers
Clinical Rheumatology, 2014
The clinical course of Behcet's disease (BD) as a multisystemic disorder with a remitting-relapsing nature is insufficiently explored. As complete remission should be aimed in all inflammatory diseases, we investigated the frequency of complete remission in patients with BD followed in long-term, routine practice. In this retrospective study, 258 patients with BD who were regularly followed in outpatient clinics were assessed. The demographic and clinical data for active organ manifestations and treatment protocols were evaluated, and "complete remission" for this study was defined as no sign of any disease manifestation in the current visit and the preceding month. Two hundred fifty-eight patients with BD (F/M 130/128, mean age 41.1±11.5 years) were included to the study. Mucocutaneous disease was present in 48.4 % (n=125). Mean visit number was 6.8±2.7, and mean follow-up duration was 45.8±36.5 months. Patients were clinically active in 67.2 % (n=1,182) of the total visits (n=1,757), which increased to 75.6 % (68.1-90.3) when the month preceding the visit was also included. The most common active manifestation was oral ulcers (39.4-63.2 %) followed by other mucocutaneous manifestations and musculoskeletal involvement. When multivariate analysis was performed, oral ulcers, which are the main cause of the clinical activity, negatively correlated with immunosuppressive treatments (β=−0.356, p<0.000) and age (β=−0.183, p=0.04). It is fairly difficult to achieve complete remission in BD with current therapeutic regimens. The reluctance of the clinician to be aggressive for some BD manifestations with low morbidity, such as mucocutaneous lesions and arthritis, might be influencing the continuous, low-disease activity state, especially due to oral ulcers, in BD patients.
Genetics Research International, 2014
The aim of this study was to investigate the 1-year period prevalence of oral aphthous ulcers (OAUs) and their association with oral health-related quality of life (OHQOL) in patients with Behçet’s disease (BD) and in the general population. In this cross-sectional study, 675 patients with Behçet’s disease (BD group) and 1,097 males and females in the Japanese general population (control group) completed both questionnaires on their OAU status during the prior year and the General Oral Health Assessment Index (GOHAI). In the BD group, 84% of patients reported experiencing an OAU during the previous year, and the mean number of OAUs/year was 13. In the control group, 31% of individuals experienced an OAU during the previous year, and the mean number of OAUs/year was one. Multivariate analysis indicated that both BD patients (OR, 6.2; 95% CI, 4.8–8.0) and controls (OR, 2.6; 95% CI, 2.0–3.5) who had OAUs at least twice per year were more likely to have GOHAI scores below the norm than ...
Acta dermatovenerologica Croatica : ADC, 2013
Recently, family history and increased frequency of some isolated manifestations of the disease in relatives of patients have been thought to play an important role in the etiopathogenesis of Behçet's disease (BD). Family history has been proposed to participate in diagnostic criteria. Investigating features of patients with different family histories may give an additional insight in understandings BD. The aim of this study was to explore the effect of familial occurrence and family history of recurrent oral ulcers (ROUs) on the clinical features of BD. We analyzed retrospectively 141 BD patients according to the International Study Group criteria. Family history of BD was present in 31.2%, family history of ROUs without BD in 31.9%, and negative family history for BD and ROUs in 36.9% of study patients. All patients were evaluated with respect to demographic and clinical features. There was no significant difference in most clinical features among patients with different famil...
Oral ulcer activity in Behcet’s disease: Poor medication adherence is an underestimated risk factor
European Journal of Rheumatology, 2017
The aim of this study was to evaluate the relationship between oral ulcer activity and medication adherence according to gender in Behçet's disease (BD) patients. Material and Methods: The study group included 330 BD patients (F/M: 167/163, mean age: 38.5±10.5 years). Oral ulcer activity and medication adherence were evaluated in the previous month. Medication adherence was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS-8) having a score range of "0" to "8" with high scores indicating better adherence. Low adherence was defined as <6 points on MMAS-8. Results: Over half of the group had active oral ulcers (n=219, 66.4%) within the month preceding the visit. The number of oral ulcers was significantly higher in female patients with low medication adherence (2.39±3.24) than in the rest of the female group (1.28±2.05; p=0.023). Although a similar trend was also observed in male patients (2.14±3.3 vs. 1.81±2.31), a significant relationship was not observed (p=0.89). The frequency of medication intake per day was lower in patients with high medication adherence than in the rest of the study group (p=0.04). Conclusion: Low medication adherence is a hidden risk factor in the management of BD. Poor adherence was associated with oral ulcer activity in female BD patients.
Clinical and experimental rheumatology
The aim of this prospective study was to detect minimal clinically important improvement (MCII) of oral health impact profile-14 (OHIP-14) for assessing the effect of treatments for oral ulcers in Behçet's disease (BD). BD patients with active oral ulcers (F/M:36/22) were selected. Baseline and follow-up data were collected by clinical examinations and questionnaires. Patients rated their global impression of change (PGIC) measured by a transitional question. MCII was defined as the difference in mean change from baseline in OHIP-14 between patients with no response to therapy and patients with next higher level of response. Approximately one third (29.3 %) of the patients expressed an improvement during control examinations. A significant correlation was observed between raw change in OHIP-14 score and change in number of oral ulcers (r=0.69 p=0.017). Inactive patients increased from 44.1% in baseline to 58.8% in follow-up examination. A trend towards decreased number of oral u...
Clinical and experimental rheumatology, 2019
OBJECTIVES The aim of this multicentre study was to understand patients' needs and to evaluate the oral ulcer activity with the Composite Index (CI), according to different treatment modalities in Behçet's syndrome (BS). METHODS BS patients (n=834) from 12 centres participated in this cross-sectional study. Oral ulcer activity (active vs. inactive) and the CI (0: inactive vs. 1-10 points: active) were evaluated during the previous month. The effects of treatment protocols [non-immunosuppressive: non-IS vs. immunosuppressive: (ISs)], severity (mild vs. severe), disease duration (<5 years vs. ≥5 years) and smoking pattern (non-smoker vs. current smoker) were analysed for oral ulcer activity. RESULTS Oral ulcer activity was observed in 65.1% of the group (n=543). In both genders, the activity was higher in mild disease course with non-IS treatment group compared to severe course with ISs (p<0.05). As a resistant group, patients with mild disease course whose mucocutaneous...
European Journal of Rheumatology, 2018
The assessment of contributing factors to oral ulcer presence in Behçet's disease: Dietary and non-dietary factors Introduction Behçet's disease (BD), first described by Turkish dermatologist Dr. Hulusi Behçet in 1937, is a multi-systemic, chronic inflammatory disorder characterized by mucocutaneous, ocular, vascular, musculoskeletal, and neurological involvement (1, 2). Several auto-inflammatory features such as recurrent self-limited symptoms, notable host predisposition, and an abnormal inflammatory process have been described for BD course (1, 3, 4). A close relationship between the oral environment and disease course is present, and oral microbial infectious foci have been implicated in the etiopathogenesis of BD (5-9). Nowadays a diverse microbial pattern has also been observed in some microbiome studies (8, 10, 11). Oral ulcer (OU), a keystone for the diagnosis of the disease, is usually the initial symptom in most patients, and is a critical component for the evaluation of the disease activity and treatment response in clinical practice (12). Since oral ulcers negatively affect the daily life of patients, poor oral health related quality of life commonly observed (13-15). Even though several treatment choices are present, the prognosis and the outcomes are still not satisfactory for mucocutaneous involvement in BD (16, 17). Some environmental factors such as mechanical factors, smoking patterns, and fatigue may affect the presence of oral ulcers (18). Some foods with acidic, salty, spicy, and hard nutrients might also easily irritate oral mucosa to form oral ulcers (19-21). However, the studies investigating these factors are still limited, and the aim of this study was to assess the contributing factors for oral ulcer presence in BD.