The link between periodontitis and rheumatoid arthritis

By Prof Johan Hartshorne

Intercare Tyger Valley Medical and Dental Centre & Visiting Professor, Department of Periodontics and Oral Medicine, University of Pretoria.

Periodontal disease (PD) and rheumatoid arthritis (RA) are two common chronic inflammatory diseases affecting humans worldwide.

What is periodontitis?

Periodontal disease (periodontitis) is a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth. It is a major cause of tooth loss and thus has a negative impact on chewing function, aesthetic appearance and quality of life.

The bacteria responsible for periodontitis can enter your bloodstream through your gum tissue, affecting your lungs, heart, joints and other parts of your body.

The risk of getting periodontitis is increased in individuals who are diabetic; use tobacco; have decreased immunity and have poor oral hygiene habits.

Signs and symptoms of periodontitis:

  • Swollen, bright red or purplish gums
  • Gums that pull away from your teeth (recede) and loose teeth.
  • Pus between your teeth and gums
  • Bad breath
  • Bad taste in the mouth

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune disorder that can cause chronic inflammation. Certain infections, such as periodontal disease might trigger the activation of the immune system in susceptible individuals, thus increasing the risk of RA. Rheumatoid arthritis can eventually result in bone erosion, permanent joint destruction and joint deformity.

What is the link between periodontal disease and rheumatoid arthritis?

Studies and trials are increasingly highlighting significant associations between periodontitis and rheumatoid arthritis. Recent findings indicate that infection with Porphyromonas gingivalis, a key pathogen in periodontal disease, precedes RA and that the bacterium is a likely factor in the initiation and maintenance of the autoimmune inflammatory responses that occur in rheumatoid arthritis.

Individuals with PD are at increased risk of developing RA, and vice versa. Periodontal disease is at least 2-fold more common in patients with RA. In addition, the clinical course of PD is more severe in patients with RA.

How can I prevent these crippling diseases?

Rheumatoid arthritis

Currently, there is no known specific prevention or cure for rheumatoid arthritis. New effective drugs are increasingly available to treat the disease and prevent deformed joints. In addition to medications and surgery, good self-management, including exercise, are known to reduce pain and disability.

Periodontal disease

The best way to prevent periodontitis is to adopt a daily routine of good oral hygiene. Regular dental checkups can greatly reduce your chance of developing periodontitis. If you have risk factors such as having dry mouth, taking certain blood pressure medications or smoking, you may need professional cleaning and check-ups more often.

Periodontal disease that is diagnosed early can be easily managed and treated by your dentist or oral hygienist by using minimally invasive procedures. The sooner you seek care from your dentists, the better your chances of reversing damage from periodontitis, potentially preventing other serious health problems.

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