By P., Piero D.D.S.
It may seem strange how some diseases are linked, but as more and more research is done, we find those links do exist. Take rheumatoid arthritis, an autoimmune disease. Symptoms include pain, swollen joints and stiffness. Several studies examining the relationship between rheumatoid arthritis and periodontal disease have been made in the past ten years. Perhaps the strongest statement made by any of the studies was from Australia and reported in the Journal of Periodontology, “The results of this study provide further evidence of a significant association between periodontitis and rheumatoid arthritis.” The researchers measured for periodontitis using probing depths, attachment loss, bleeding scores, plaque scores, and radiographic bone loss scores. Their measurements for rheumatoid arthritis included tender joint analysis, swollen joint analysis, and pain index, physician’s global assessment on a visual analogue scale, health assessment questionnaire, levels of C – reactive protein (CRP), and erythrocyte sedimentation rate.
In both diseases, the inflammation destroys the soft and hard tissue. The inflammation is caused by the toxins from bacterial infection. Even historically, some treatments for arthritis were to pull teeth or give antibiotics to the patient to relieve their arthritic pain. Once the inflammation from their teeth was controlled, the patients got better. More recently, two studies in 2012 found that the fewer the teeth and individual had, the more severe the arthritis. Out of a normal 32 teeth, those with fewer than 20 teeth were eight times more likely to have swollen joints.
As with periodontal disease and other systemic diseases, rheumatoid arthritis is a chronic inflammatory disease. Chronic infection shows up in the blood by increased levels of CRP. One inflammatory disease that produces high levels of CRP exacerbates the other. And this is also true with arthritis. And those with rheumatoid arthritis tend to have more periodontal disease. Treating the periodontal disease often gives relief to the arthritis. And treating the arthritis with antibiotics often improves the gum disease. More studies are being conducted to ascertain more quantitative data on the association between the two diseases. The once thought of as myth, is slowly being proven as fact, that periodontal disease impacts total health.
The issue is more complex than just stating that arthritis causes periodontal disease or that periodontal disease causes arthritis. However, it is evident that there is a link. And more importantly, providing the best oral care possible and getting periodontal therapy if you have the disease, will also positively impact your arthritis and potentially reduce your pain.
Dr. Piero, a Holland, MI dentist for over thirty years, is the inventor of Dental Air Force (http://www.dentalairforce.com). Articles published are on periodontal health related to heart disease, respiratory health, diabetes, strokes, and other systemic diseases. He is the Executive Editor for Journal of Experimental Dental Science, a contributing author to Hospital Infection Control: Clinical Guidelines and soon-to-be published book, Put Your Money Where Your Mouth Is.