What Is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a form of inflammatory arthritis and an autoimmune disease.  For reasons no one fully understands, in rheumatoid arthritis, the immune system—which is designed to protect our health by attacking foreign cells such as viruses and bacteria—instead attacks the body’s own tissues, specifically the synovium, a thin membrane that lines the joints.  As a result of the attack, fluid builds up in the joints, causing pain in the joints and inflammation that’s systemic—meaning it can occur throughout the body.

  • People with RA are 8 times more likely to develop gum disease than people with RA.
  • In patients suffering from both RA and gum disease, 18 percent had severe periodontal disease, and 32 percent had moderate periodontal disease.
  • By comparison, about 10-15 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 rheumatoid arthritis cleared up their gum disease, their pain and other arthritic symptoms got better.
  • Gum disease ranges from gingivitis, a mild form that causes swollen, tender gums, to more serious forms like periodontitis, in which inflammation affects the tissue and bone supporting the teeth.  Some people with RA also develop Sjogren’s syndrome, an autoimmune disease of the glands, which causes dry mouth and increased tooth decay.
  • 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.
  • Experiment with new types of floss.  Try floss holders, floss picks or threaders.
  • “Pump up” your paste.  Toothpaste in a pump might be easier for you to use than a tube you have to 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 day when joints are less stiff can make you more comfortable.
  • Ask for a neck or leg pillow for better support in the dentist’s chair.






Courtesy of Next Level Practice

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