Oral Health and Arthritis

April 14, 2017

Periodontal disease and rheumatoid arthritis

The mouth may seem like a strange place to search for a culprit in a disease that primarily affects the joints. But a recent collaboration by a group of multidisciplinary researchers suggests that one type of oral bacteria may be an important trigger in about half of rheumatoid arthritis (RA) cases.

The findings, published in Science Translational Medicine late last year, appear to confirm something that’s been suspected for at least a century: In some cases, gum-disease causing oral bacteria may set off a cascade of events that leads to the autoimmune form of arthritis.

Evidence for the link between periodontal disease and rheumatoid arthritis

Oral Health and Arthritis

Oral Health and Arthritis

Recent research has indicated an association between two chronic, noncurable diseases – periodontal disease and rheumatoid arthritis. Rheumatoid arthritis is a debilitating, autoimmune, joint destroying, chronic inflammatory condition of unknown etiology. It affects about 1% of the adult population. Anyone who has experienced rheumatoid arthritis (RA) firsthand, or in a family member or friend, understands how life-changing it can be.

Evidence for the link between periodontal disease and rheumatoid arthritis comes from the commonality of their pathogenesis and clinical presentation. The immunological and pathological processes occurring in periodontitis and RA are nearly identical. Both conditions are characterized by chronic inflammation in a soft-tissue site adjacent to bone. In both diseases, the inflammatory mediators released include IL-1, IL-6, and TNF-alpha, among others. Furthermore, antibodies to the same bacterial species are found in periodontal tissues and synovial tissues in individuals with RA. There is also a strong genetic association between the two diseases.

Dental Tips for the Rheumatoid Arthritis Patient by the Johns Hopkins Arthritis Center

The clinical manifestations occurring in both periodontitis and RA are also remarkably similar – pain, swelling, and tenderness. If left untreated, the chronic inflammatory processes ultimately lead to bone destruction.

Bacterial infections of the mouth can be a problem for people who are taking immunosuppressive medications. Signs of infections include swelling around your tooth or over the jaw, severe pain, fever, and swollen nodes around your jaw. Different oral infections can  occur:

  • Bacterial infections can cause swelling around your tooth or over the jaw, severe pain, fever, and swollen nodes around your jaw.
  • Fungal infections can cause a white coating or clumping that can develop on the tongue or around the inside of your cheeks.
  • Oral ulcers can also occur in people taking methotrexate. A folic acid supplementation can help with reducing ulcers.

Brush and floss regularly, avoid chewing tobacco and smoking cigarettes. Be sure to see a capable dentist like Dr. Foad Farhoumand or Dr. Farah Farhoumand regularly and tell your doctor or treating rheumatologist about any new oral health issues.