Oral Candidiasis in Patients with Rheumatoid Arthritis: A Hospital-Based Cohort Study

Cristhiane Almeida Leite da Silva1, 2, 3, *, Gabriela Camarneiro Siqueira3, Vander Fernandes1, 3, Luiz Evaristo Ricci Volpato1, 2, Walkiria Shimoya-Bittencourt1, 2, Alexandre Meireles Borba2, Bernar Monteiro Benites4, Ageo Mario Candido da Silva1
1 Program on Environment and Health, University of Cuiabá, Cuiabá, MT, Brazil
2 Program on Integrated Dental Sciences, University of Cuiabá - UNIC, Cuiabá, MT, Brazil
3 Department of Hospital Dentistry, Cuiabá General Hospital, Cuiabá, MT, Brazil
4 Oral Medicine Department, Sírio-Libanês Hospital, São Paulo, SP, Brazil

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© 2023 Leite da Silva et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Program on Integrated Dental Sciences, University of Cuiabá - UNIC, Cuiabá, MT, Brazil;
Tel: 55 65993490154; E-mail:



Rheumatoid (RA) arthritis is a chronic autoimmune disease characterized by symmetric polyarthritis and systemic inflammation. Systemic complications due to RA and its treatment may affect oral health.


To assess the prevalence and predisposing factors for oral candidiasis in Rheumatoid Arthritis patients treated at a rheumatology referral hospital.


This is a longitudinal study of a panel of repeated measures performed on patients attending the Rheumatology and Oral Diagnosis Outpatient Clinic of the General Hospital of Cuiabá. Patients were followed up between 2018 and 2019, with the information recorded in the medical records and subsequently extracted. A generalized estimation equation model was used to assess the association between oral candidiasis and RA.


In the final model, in crude (bivariate) analysis, the use of prednisone (OR 8.3) and tocilizumab (OR 3.7) were significantly associated with oral candidiasis. In the multivariate generalized estimation equation model, the use of prednisone (OR 9.9) and the presence of hyposalivation in male patients (OR 1.8) were the variables that remained statistically associated with oral candidiasis.


The use of immunosuppressive drugs and the low rate of salivary flow in male patients increase the risk of oral candidiasis in patients with rheumatoid arthritis, reinforcing the importance of stomatological monitoring, a preventive approach and early diagnosis of this pathology.

Keywords: Rheumatoid Arthritis, Oral Candidiasis, Oral Manifestations, Hyposalivation, Xerostomia, Infections, Antirheumatic Agents.