In the U.S., the number one cause of adult tooth loss is periodontal (gum) disease.
According to the Centers For Disease Control & Prevention (CDC), over 47 percent of American adults are living with some level of gum disease. For those who are 65 and older, this figure jumps to 70 percent.
As devastating as tooth loss can be, just as debilitating are the health problems associated with gum disease bacteria. The inflammatory reactions triggered by the infectious bacteria of gum disease have been linked to coronary artery disease, stroke, some cancers, diabetes, preterm babies, and impotency.
Research has also shown a rather close association between gum disease and rheumatoid arthritis (RA).
Years ago, researchers noticed an RA-perio trait among people with rheumatoid arthritis. While RA sufferers had gum disease more often, they observed that people with gum disease tended to have RA more often.
As research delves deeper into the connection, it appears that the association is much more complicated than previously thought. Findings suggest that oral bacteria could actually be a cause of rheumatoid arthritis or that existing periodontal disease could be a trigger for developing RA.
In the past, doctors felt that periodontal disease was a result of RA itself since stiff, painful hands make it challenging to maintain good oral hygiene. They also suspected that medications prescribed to treat RA could be a factor since the drugs, which suppress the immune system, inhibited the body’s ability to fight harmful oral bacteria.
In 2008, however, German researchers found that patients with RA were nearly eight times as likely to have gum disease. Another study showed twice as many cases of periodontal disease in patients with RA as compared to those without RA. The study also showed that anti-rheumatic drugs were not a contributing factor since none of the participants with arthritis had taken immune-suppressing medications.
Among recent studies are those indicating that tooth loss from periodontal disease could even be an warning sign of one’s risk of developing RA. One study noted that the more teeth missing, the higher one’s potential for developing arthritis. This study tracked over 600 participants with early arthritis who had varying numbers of remaining natural teeth.
Each participant was started on periodontal therapy and evaluated again after six months. As a result, more than half showed positive response to treatment with nearly a third experiencing moderate response and 16 percent showing no response. (Those in the “no response” group had the least number of remaining teeth.) Those with 10 or fewer teeth had more severe levels of arthritis compared to those with 10 teeth or more.
Yet, another study of over 350 participants who had developed swollen joints found that the fewer the teeth remaining, the greater their risk for joint inflammation.
A study of over 6,000 men and women were given four medical exams between 1987 – 1998, including assessments for gum disease between 1996 – 1998. Those who had moderate to severe periodontitis (advanced gum disease) had more than twice the risk of RA compared to those with mild or no periodontitis.
Study after study continually reveals a closely link between periodontal disease and rheumatoid arthritis. And, research findings are now showing that periodontal disease in RA sufferers doesn’t necessarily occur after RA’s onset. In some cases, RA follows periodontal disease.
The origination and path of this reaction remains in research. Most recently, researchers have been studying the RA-periodontal disease connection in similarities between RA-affected joint tissues and diseased oral tissues. It is clear that the tissues in the mouth of a periodontally-compromised individual and the tissues of the joint in RA have a number of likenesses. Research has also shown a genetic link between the two.
If oral bacteria are involved in the development of RA, or inflammation in the mouth fuels joint inflammation, researchers are hopeful that resolving periodontal disease could help prevent or treat RA. One study at Case Western University School of Dental Medicine and University suggests that may be a strong possibility.
In the study, 40 people with both RA and periodontal disease were monitored by researchers. The results revealed that those who received treatment for gum disease experienced significantly more improvement of their RA symptoms than those who received treatment for RA only.
With such a high prevalence of periodontal disease in patients with rheumatoid arthritis and the likely connection between the two, individuals who have RA should be especially committed to maintaining good oral health. Regular dental check-ups, a healthy diet, and a thorough brushing and flossing regimen are important.
Even though RA sufferers may struggle with their oral hygiene at home due to stiff, painful hands, our hygienists can make helpful recommendations and work with you on a proper, comfortable technique. The can also recommend alternatives to make the process easier, such as using an electronic flosser rather than string floss.
RA sufferers should begin by making certain their existing oral health is at an excellent level. Call 219-987-5733 to schedule an initial examination, or tap here to begin. We also offer a free consultation where we can discuss your individual needs and concerns in a private setting.