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Oral Health and RA – There Is a Connection

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The past year for me meant spending way too much time in dental offices. After several successful years with it, I lost an implant in the back of my mouth. The bone beneath and on either side of it disappeared. No rhyme or reason to it.

My dentist couldn’t understand why since the one right next to it was working nicely with strong bone beneath it.  Being the writer I am, I had to research the whys and wherefores about this strange happening.

And a few months later, I was informed that due to a few deep pockets in my teeth, I need a descaling process. My mind immediately wanted to know why, all of a sudden, these dental issues attacked.

Not one of the numerous rheumatologists I saw over the years ever mentioned any correlation between dental health and rheumatoid arthritis.  But I have since learned that there is a connection.

Periodontal disease affects the tissues around the teeth, including gums, ligaments and bone into which a tooth is anchored. 

RA Patients with Sjogren’s Are Prone to Dental Disease

Those of us with Sjogren’s Syndrome are more likely to have dental issues. Sjogren’s damages the glands that secrete fluids, like the salivary glands in the mouth. This leads to cavities in the teeth, extremely dry mouth and tooth loss.

Lower saliva output hurts teeth in another way, because saliva contains proteins that reduce bacteria in the mouth.

Inflammation May Be the Common Connector

A 2016 study at Johns Hopkins Arthritis Center identified a type of bacteria called Aggregatibacter actinomyceterncomitans as the source for chronic gum inflammation that leads to periodontal disease. Scientists theorize the inflammatory response to the bacteria may spread throughout the body, triggering RA symptoms.

While that is still a theory, the connection appears to be increasingly accepted in the medical community. ” Inflammation is a protective immune system response to foreign bodies like viruses and bacteria. But with autoimmune diseases like rheumatoid arthritis, the immune system mistakenly triggers inflammation even though there are no viruses or bacteria to fight off,” says Scott Zashin, MD, clinical associate professor of medicine at the University of Texas Southwestern Medical School and attending physician at Texas Health Presbyterian Hospital in Dallas. 

Dr. Zashin believes that controlling inflammation through better dental care could help reduce the incidences and severity of RA.

Researchers at Case Western found that when people with a severe form of rheumatoid arthritis successfully treated their gum disease, their pain and other arthritis symptoms got better.

Connection between Oral Health & RA in Clinical Studies

A number of large epidemiological studies published show correlations between rheumatoid arthritis and periodontal disease. One study showed that RA patients with periodontal disease showed less improvement in their rheumatoid disease activity with autoimmune medications. Some studies showed that RA patients with alveolar bone (the ridge of bone that holds the tooth socket) loss related to their periodontal disease parallel RA erosions in other sites.

Conclusions indicate that periodontal disease is common in all stages of rheumatoid arthritis, and specific strains of oral bacteria may trigger RA symptoms.

Periodontal Disease & Oral Health and RA

Periodontal disease begins with gingivitis and may progress to a chronic, inflammatory condition. Without proper and timely treatment, it may progress to periodontal disease and could result in bone destruction and tooth loss. A study from Johns Hopkins Arthritis Center found that 70% of the 100 RA patients studied had at least moderate gum disease where only 35% of general population have gum disease.

Frequent Dental Visits May Protect Your Oral Health from RA problems

I waited a year between dental check-ups and cleanings, when I should have been going every 6 months. Had I done so, the deep cleaning – or descaling of my teeth might have been avoided. Lesson learned! If you notice any symptoms of periodontal disease, such as loose teeth, red or swollen gums, bleeding gums, bite changes or receding gums, see your dentist as soon as possible.

Meanwhile, if you smoke, stop smoking. Brush and floss your teeth twice daily and watch for any changes in your mouth and gums.

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