Psoriatic arthritis is increasingly recognized as a systemic inflammatory disease with multiple comorbidities, yet the full spectrum of dental complications associated with psoriatic arthritis has not been clearly defined. This nationwide population based cohort study evaluated whether patients with psoriatic arthritis are at elevated risk of diverse dental diseases. Using a nationwide population-based health insurance database, we identified 40,920 newly diagnosed psoriatic arthritis cases and 204,468 age- and sex-matched controls. Dental outcomes included dental caries, pulp and periapical disease, periodontal disease, gingival changes and tooth loss. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs). PsA patients exhibited significantly increased risks of dental caries (aHR 1.342), pulp and periapical disease (aHR 1.633) and periodontal disease (aHR 1.268). Subtype analyses revealed elevated risks for acute and chronic gingivitis, aggressive and chronic periodontitis, periodontosis and unspecified periodontal disease. These findings highlight the need for comprehensive oral health surveillance in patients with psoriatic arthritis.
