Scientists have long been aware of a connection between gum disease and systemic diseases such as heart disease and diabetes. A new growing body of evidence now appears to link gum disease and arthritis. While the evidence is not conclusive, a strong correlation between the two exists.
Rheumatoid Arthritis (RA) is a form of inflammatory arthritis and an autoimmune disease. The immune system is designed to protect our health by attacking foreign cells such as viruses and bacteria, but in people with RA, turns against the body’s own tissues, specifically the synovium, a thin membrane that lines the joints. As a result of the attack, fluid builds up in the joints, causing pain in the joints and inflammation.
Periodontitis and RA share similar disease mechanisms including the inflammatory infiltrate and bone loss patterns. They are both chronic inflammatory diseases which will eventually result in the loss of soft tissue (periodontium) and alveolar bone for periodontitis and synovitis as well as bone erosion for rheumatoid arthritis.
Patients suffering from more severe forms of periodontitis have a higher prevalence of arthritis. Good evidence suggests that people affected by rheumatoid arthritis present signs of periodontitis, whilst patients suffering from RA have elevated immune responses against specific periodontal bacteria both in serum and synovial fluid when compared to healthy controls.
Because some types of arthritis increase the risk of oral health issues, it’s important to establish good home hygiene habits, and a regular schedule of dental care at the dentist office. Here’s what to aim for:
- Follow a regular cleaning routine. Brush twice a day for two minutes, and floss once a day. If arthritis in your wrists or hands makes gripping a toothbrush or twirling floss around your fingers a problem, using small pre-threaded flossers and an electric toothbrush may help.
- Using the right toothpaste is also important if you have dry mouth symptoms in addition to arthritis. Experts recommend avoiding whitening or abrasive toothpastes, and choosing a brand with fluoride that is especially labelled for “dry mouth.” A 0.05% sodium fluoride mouth rinse before going to bed can also help reduce the risk of cavities.
It is unknown whether gum disease precedes RA or RA precedes gum disease. What is known is that it is extremely important to take oral care seriously if you have arthritis. Regular dental visits are a must. In fact, some health professionals recommend those with RA have as many as four annual cleanings, as research suggests that treating dental problems early on will result in decreased symptoms in patients with severe arthritis. One study showed that reversing gum disease through professional dental care actually decreased RA sufferers’ overall pain level, number of swollen joints, and morning stiffness.
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