Assessing the efficacy of nonsurgical periodontal treatment on rheumatoid arthritis: an umbrella review.

This umbrella review evaluates the efficacy of nonsurgical periodontal treatment (NSPT) on rheumatoid arthritis (RA) by synthesizing evidence from nine systematic reviews and meta-analyses published up to August 2024. The findings suggest that NSPT, which includes scaling and root planing with or without adjunctive therapies, may reduce RA disease activity as measured by the Disease Activity Score 28 (DAS28) and improve some inflammatory markers, although evidence quality ranges from weak to suggestive due to methodological limitations such as small sample sizes and heterogeneity in periodontal disease classification. While NSPT shows potential benefits in managing RA symptoms in patients with periodontitis, the review highlights the need for well-designed, large-scale randomized controlled trials with standardized protocols to confirm these effects and clarify underlying biological mechanisms. Clinicians are advised to consider the bidirectional relationship between periodontitis and RA when developing integrated treatment strategies.