We’re kicking off a new blog series here at Dental Care of Vashon! Throughout the rest of 2019, we will highlight different autoimmune diseases bimonthly and discuss their impacts on oral health, and vice versa. Autoimmune diseases are wide-ranging conditions that affect many systems of the body. Typically, these diseases cause the body to attack its own cells, wreaking havoc and causing painful and sometimes debilitating symptoms.
In the United States alone, over 23.5 million people suffer from at least one autoimmune disease; moreover, women experience this more often than men. Consequently, researchers have hypothesized that hormonal changes may play a role. To begin our series, we’ll examine the impact of Rheumatoid Arthritis (RA) on oral health.
Possible Links
Currently, researchers have proposed a couple of different hypotheses about individuals with RA also suffering from periodontal disease. Firstly, one such hypothesis links easily to RA’s symptoms. Specifically, RA can cause severe pain and stiffness in any of the body’s joints. As a result, limited mobility in joints, including those in hands, can make homecare, such as brushing and flossing, more challenging.
Periodontal Disease
Furthermore, a 2008 German study found that patients with RA were 8 times more likely to develop periodontal disease. Notably, the study indicated that poor oral hygiene alone did not explain such a significant increase, thus prompting us to look deeper into the cellular level of disease.
Oral Tissue
Interestingly, the oral tissue with periodontal disease and joints with RA share some similarities. As we well know, the inflammation of periodontal disease destroys the bone and tissue surrounding the teeth. Similarly, inflammation also breaks down joints and causes pain associated with RA. Researchers have found many of the same proinflammatory proteins in both diseases (Tumor Necrosis Factor (TNF), Interleukin-1, and Interleukin-6). Additionally, a different study from Israel suggested that genetics may play a role in elevated risk for RA.
Oral Tissue
The current and growing knowledge surrounding these factors leads to a better understanding of the entire disease process. One of the early markers of RA is the increase of antibodies to citrullinated peptides. Citrullination, the scientific term for a change in cell structure, leads the body to see it as a foreign entity and helps the body release anti-cyclic citrullinated (anti-CCP) antibodies.
Subsequently, these antibodies attack the cells thought to be foreign, even though they are, in fact, cells of the body. The link to periodontal disease lies in bacteria. Researchers have found that at least one strain of bacteria commonly associated with periodontal disease causes the process of citrullination. Consequently, a 2009 study concluded that certain oral bacteria could cause RA and/or that periodontal disease may induce the disease process of RA.
Treatment
Given all this information, we can clearly see the link between periodontal disease and rheumatoid arthritis. Therefore, treating each disease is one of the best ways to control them. If you suffer from uncontrolled periodontal disease, you will likely benefit from scaling and root planing to bring it under control. Additionally, maintaining better oral health with frequent dental visits is crucial.
Moreover, it’s important to work with your physician to control your RA. If you have RA and struggle with homecare due to stiff or painful joints, speak with your hygienist. You may benefit from different dental tools, including an electric toothbrush or water flosser.
Dental Care of Vashon
At Dental Care of Vashon, we strive to work closely with our patient’s physicians to care for your entire health. If you have RA, it’s imperative to maintain good home care and frequent visits with your hygienist. Don’t forget to visit our Facebook!
In conclusion, look for our upcoming blogs highlighting other autoimmune diseases over the coming months. Although these conditions often take a backseat to smoking and diabetes when discussing periodontal disease, we hope that continued studies will further our understanding of these elusive diseases’ etiology. Lastly, if you know someone with RA, please share this link with them!
References
Arthritis Foundation – https://www.arthritis.org/living-with-arthritis/comorbidities/gum-disease/ra-and-gum-disease.php
Johns Hopkins Arthritis Center – https://www.hopkinsarthritis.org/arthritis-news/5-dental-tips-for-the-ra-patient/
Colgate – https://www.colgate.com/en-us/oral-health/conditions/immune-disorders/ada-06-rheumatoid-arthritis-and-gum-disease-risk
National Library of Medicine, National Institutes of Health – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495574/
Faster, better, and more comfortable care is available at Dental Care of Vashon. Our team views you as a key part of our dental family. This inspires us to go the extra mile for your dental health.