Rheumatoid Arthritis

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is classified as an autoimmune disease as well as an inflammatory type of arthritis. The immune system is a variety of processes that normally protect the body by fending off viruses and other foreign cells. In people with RA, this system attacks natural, healthy cells – particularly a membrane in the joints called synovium – for reasons that are not fully understood, despite extensive scientific research. This immune system attack causes an accumulation of fluid in the joints, triggering systemic (whole body) inflammation along with joint pain.

  • People with RA are 8 times more likely to develop gum disease than people without RA.
  • In patients suffering from both RA and periodontal disease, 32 percent had moderate gum disease, while 18 percent had severe gum disease.
  • In contrast, only ten to fifteen percent of adults without RA have moderate to severe periodontal disease.

What is the link between gum disease and rheumatoid arthritis?

Rheumatoid arthritis is due to an overactive immune system. Both diseases have inflammation in common, which may explain the connection. Inflammation is a protective immune system response to substances like viruses and bacteria. In autoimmune diseases like rheumatoid arthritis, the immune system mistakenly triggers inflammation, although there are no viruses or bacteria to fight off. The inflammation causes joints to become swollen, painful and stiff.

Treatment Options:

  • Controlling the inflammation through better dental care could play a role in reducing the incidence and severity of RA.
  • Studies have shown that when people with a severe form of RA successfully treated periodontal disease, they experienced an improvement in joint pain and other RA symptoms.
  • Gum disease ranges from gingivitis, a mild form that causes swollen, tender gums, to more serious forms such as periodontitis, which involves damage and inflammation of bone tissue and soft tissue surrounding teeth. Additionally, some rheumatoid arthritis patients also have an autoimmune condition impacting the glands, known as Sjogren’s syndrome, which decreases saliva flow, thus increasing the risk of cavities.
  • If you have gingivitis, it can be reversed with twice-yearly dental cleanings and good at-home care. People with more severe gum disease will need more extensive treatment from a dental professional to control the disease.
  • People with RA sometimes have a hard time maintaining good oral hygiene because the disease can affect the joints in their hands, making brushing and flossing difficult. Electric toothbrushes can be a great help to patients who have trouble brushing.
  • Gum disease has been linked to other conditions like heart disease, stroke and diabetes, as well as RA. Taking care of your mouth may very well improve your overall health.

Tips from the American Dental Association to make dental care easier to manage:

  • Reinvent your toothbrush. To better grip your brush, add a tennis ball or bicycle handle to the end.
  • Try new flossing techniques. Experiment with floss threaders, holders, or picks.
  • “Pump up” your paste. Toothpaste in a pump might be easier for you to use than a tube you must squeeze.
  • Make the most of mouthwash. Buy one with fluoride to protect your teeth from cavities.
  • Don’t light up. Smoking is a big risk factor in developing gum disease, and it can interfere with the success of some treatments.
  • Speak to your dentist. Tell your dentist about your rheumatoid arthritis.
  • Sometimes shorter appointments scheduled later in the afternoon or evening, after joints have loosened up increase your comfort.  
  • Request a neck or leg pillow for better support in the dentist’s chair.

Review by Marietta Correale

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