July 31, 2013

Is There a Connection Between Gum Disease and Rheumatoid Arthritis?

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 to rheumatoid arthritis (RA). While the evidence is not conclusive, a strong correlation between the two exists.

Rheumatoid arthritis is a chronic inflammatory disease that affects the joints by causing pain, stiffness, and inflammation. It currently affects .5% to 1% of the global population1. Periodontal disease is also a chronic inflammatory condition; it primarily affects gum tissue. Evidence from one study states that over 75% of Americans have some form of gum disease, yet most people are unaware they have it2. Gingivitis, the earliest stage of gum disease, is typically marked by noticeably inflamed gums, as well as soreness and/or bleeding during brushing or flossing. If not treated, plaque accumulates at the gum line, causing further inflammation and gum recession. When the tissue of the pockets surrounding the teeth is damaged, harmful bacteria have access to the bloodstream—which in turn can cause serious problems in other parts of the body3.

Researchers have found a substantial increase in the prevalence of gum disease in patients with RA compared to those without it. In addition, the incidence of RA is higher in those with gum disease than those without4. Statistics from the Third National Health and Nutrition Examination Survey (NHANES III) explain the connection between the two chronic ailments based on several key factors. Both gum disease and arthritis result from an inflammatory response, and both are characterized by an overgrowth of bacteria that release toxins destructive to supporting tissues. People affected by both diseases exhibit more anti-citrullinated protein antibodies (ACPA), which increase bodily inflammation and exacerbate both conditions5.

Of the 20 bacterial species identified as periodontal pathogens, all are linked to gum disease. The most studied is Porphyromonas gingivalis (P. gingivalis)6. Researchers from Germany’s Martin Luther University Halle-Wittenberg recently examined samples of synovial fluid (the fluid within joint capsules) from 42 patients with RA and found DNA matching oral bacteria—P. gingivalis in particular. The study concluded that those with RA are approximately 4.5 times more likely to have P. gingivalis bacteria in their synovial fluid than those without arthritis. Furthermore, they discovered that RA patients were 12 times more likely to have oral infections from P. gingivalis7. Another study found that arthritis patients displayed a considerable increase in the levels of gingivitis bacteria, and the severity of gum disease correlated with the severity of the arthritis8.

What is the best gum disease treatment for patients with rheumatoid arthritis?

Oral health is interconnected with one’s overall health. And while the scientific community is in agreement regarding the connection between periodontal disease and rheumatoid arthritis, the exact relationship between these two destructive chronic inflammatory diseases is unknown. It is known that systemic diseases (which includes arthritis) are accompanied by an increase in the severity of gum disease9 because oral infections create a pathway for bacteria to enter the bloodstream. This can elicit an inflammatory response elsewhere10 in the body. And even though plaque buildup is recognized as one of the primary causes of periodontal disease, the progression of the disease is largely dependent on the overall strength of the subject’s immune functioning11. According to the American Academy of Periodontology, the presence of gum disease can be an indicator of several forms of systemic diseases including RA12.

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 arthritis13. One study showed that reversing gum disease through professional dental care actually decreased RA sufferers’ overall pain level, number of swollen joints, and morning stiffness14.

Finding a natural treatment for gum disease

Increasing public awareness of the connection between gum disease and systemic diseases like arthritis is important from a holistic perspective. Brushing and flossing regularly, and using all natural gum disease treatment products are key to oral health. Natural toothpastes and mouth rinses both clean and heal inflammation safely and effectively. The ingredients in Dental Herb Company’s line of oral care products are completely natural—and the quality of ingredients has proven to be effective in combating harmful bacteria, reducing inflammation and eliminating bad breath. Pure essential oils and organic herbal extracts work synergistically to maintain healthy  teeth and gums, and they’re a great alternative to the chemical products lining most commercial shelves. The best natural remedy for gum disease, lasting oral health and a reduced risk for systemic diseases is preventative care. Commit to good oral care today.

References:

  1. Ogrendik, Mesut. “Rheumatoid Arthritis Is an Autoimmune Disease Caused by Periodontal Pathogens.” National Center for Biotechnology Information. U.S. National Library of Medicine, 24 May 2013. Web. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668087/>.
  2. “Gingivitis- In-Depth Report.” Health.nytimes.com. New York Times, n.d. Web. <http://health.nytimes.com/health/guides/disease/gingivitis/print.html>.
  3. “Joint Failures Potentially Linked to Oral Bacteria.” ScienceDaily.com. ScienceDaily, 18 Apr. 2012. Web. <http://www.sciencedaily.com/releases/2012/04/120418112047.htm>.
  4.  Ogrendik, Mesut. “Rheumatoid Arthritis Is an Autoimmune Disease Caused by Periodontal Pathogens.” National Center for Biotechnology Information. U.S. National Library of Medicine, 24 May 2013. Web.
  5. Pablo, P., T. Dietrich, and TE McAlindon. “Association of Periodontal Disease and Tooth Loss with Rheumatoid Arthritis in the US Population.” Ncbi.nlm.nih.gov. U.S. National Library of Medicine, n.d. Web. <http://www.ncbi.nlm.nih.gov/pubmed/18050377>.
  6. Ogrendik, Mesut. “Rheumatoid Arthritis Is an Autoimmune Disease Caused by Periodontal Pathogens.” National Center for Biotechnology Information. U.S. National Library of Medicine, 24 May 2013. Web.
  7. Adams, Case. “Arthritis Linked to Gingivitis Bacteria.” GreenMedInfo.com. GreenMedInfo, n.d. Web. <http://www.greenmedinfo.com/blog/arthritis-linked-gingivitis-bacteria>.
  8. Adams, Case. “Arthritis Linked to Gingivitis Bacteria.” GreenMedInfo.com. GreenMedInfo, n.d. Web. <http://www.greenmedinfo.com/blog/arthritis-linked-gingivitis-bacteria>.
  9. Chi, Angela C., DMD, Brad W. Neville, DDS, Joe W. Krayer, DDS, and Wanda C. Gonsalves, MD. “Oral Manifestations of Systemic Disease.” Aafp.org. American Family Physician, n.d. Web. <http://www.aafp.org/afp/2010/1201/p1381.html>.
  10. Gude, Dilip, Rekha Rani Koduganti, Surya J. Prasanna, and Lakshmi Radhika Pothini. “Mouth: A Portal to the Body.” Ncbi.nlm.nih.gov. U.S. National Library of Medicine, 03 May 2006. Web.
  11.  Kinane, DF. “Periodontitis Modified by Systemic Factors.” Ncbi.nlm.nih.gov. U.S. National Library of Medicine, n.d. Web. <http://www.ncbi.nlm.nih.gov/pubmed/10863375>.
  12.   “Diagnosis of Periodontal Diseases.” Journal of Periodontology 74 (2003): 1237-247.Umn.edu. University of Minnesota. Web. <http://www1.umn.edu/perio/periocasepresent/text/Diagnosis_of_Perio.pdf>
  13. “Treating Gum Disease Helps Rheumatoid Arthritis Sufferers.” ScienceDaily.com. ScienceDaily, 29 May 2009. Web. <http://www.sciencedaily.com/releases/2009/05/090528135252.htm>.
  14.  “Treating Gum Disease Helps Rheumatoid Arthritis Sufferers.” ScienceDaily.com. ScienceDaily, 29 May 2009. Web. <http://www.sciencedaily.com/releases/2009/05/090528135252.htm>.

 




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