Sunday, September 20, 2015

The Link Between Periodontitis and Rheumatoid Arthritis


An article published in the September 2015 issue of the Journal of Periodontology explores the link between Periodontitis and Rheumatoid Arthritis.  Rheumatoid Arthritis not only causes joint pain but it can also predispose patients to osteoporosis, heart problems, and lung disease.  For more about rheumatoid arthritis, watch the video below.


The article in the Journal of Periodontology examines the latest information supporting a strong association between the two conditions.  Patients with Rheumatoid Arthritis have a higher incidence of periodontal disease than individuals not affected by Rheumatoid Arthritis.  Furthermore, those who have severe cases of periodontal disease tend to have more severe arthritis symptoms and vice versa.  

In addition to these trends, there is evidence that periodontal disease usually is present prior to Rheumatoid Arthritis.  This supports the possibility that mechanisms that cause periodontal disease may actually play a role in the development of Arthritis.  One mechanism that may be shared between both diseases is one involving a harmful bacterium commonly found in patients with periodontal disease, Porphyromonas gingivalis.  These bacteria can cause changes to proteins in a process called citrullination. The presence of these altered proteins is extremely specific for detecting Rheumatoid arthritis, even before a patient has symptoms.  The authors of the article conclude that a cause and effect relationship between Periodontitis and Rheumatoid Arthritis via these harmful periodontal bacteria appears biologically plausible.  Getting examined and treated for gum disease now can avoid a serious health problem later.

For those who may already be affected by Rheumatoid Arthritis, there is evidence that periodontal therapy reduces the signs and symptoms of Rheumatoid Arthritis.  When managing your arthritis, remember your gums!

As a practice, understanding how your gum health affects your overall health is of utmost importance to us.  Drs. Price and Rubino welcome any questions you may have regarding this topic.

References:

1. “Diseases and Conditions: Rheumatoid arthritis.” http://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/basics/definition/con-20014868. Last accessed 9/15/2015

2. De Smit et al. “Commentary: Periodontitis and Rheumatoid Arthritis: What do we know?” Journal of Periodontology 2015 Sep;86(9):1013-9.

3. Ortiz et al. “Periodontal Therapy Reduces the Severity of Active Rheumatoid Arthritis in Patients Treated With or Without Tumor Necrosis Factor Inhibitors.” Journal of Periodontology 2009 April;80(4): 535-540.