Exploring The Link Between RA and Gum Disease

Dr. McLeod

For patients of Dr. McLeod to enjoy a healthy, great-looking smile, they must avoid the common oral health problems that contribute to the development of tooth decay and gum disease. Additionally, patients who want to enjoy quality health overall must also avoid these same oral health problems. That’s because a growing amount of research has found links between poor oral health and a number of chronic conditions that include heart disease, stroke, diabetes, dementia and even arthritis.

While most patients know that severe gum disease can cause the underlying bone and connective tissue in our mouths to deteriorate – leading to permanent tooth loss – many could be surprised to know that the inflammation caused by gum disease can also impact the health of our joints. In fact, this relationship also appears to work as a two-way street. A recent analysis found that individuals with rheumatoid arthritis (RA) had a 13 percent higher risk for severe gum disease when compared to those without RA.

The Link Between Gum Disease and RA

Although researchers have yet to identify a definitive cause and effect relationship between severe gum disease – also known as periodontitis – and systemic inflammatory disease, researchers have hypothesized that in patients with periodontitis, harmful oral bacteria responsible for the development of gum disease may actually enter the bloodstream and travel throughout the body. When this occurs, it increases the level of systemic inflammation in the body, thereby increasing the risk for the development of inflammatory diseases like RA.

Similarly, RA involves the damage to bone and connective tissue. While periodontitis is an immune-inflammatory disease, RA is an inflammatory autoimmune disease. Even though different, researchers have noted that both conditions share many similarities in both their molecular and cellular biology.

In both conditions, polymorphonuclear leukocytes, macrophages and T lymphocytes infiltrate cells in the body and cause soft and hard tissue destruction. The inflammatory process caused by both types of diseases is due largely to pro-inflammatory cytokines.

Citrullination, a process that involves the breakdown of amino acid, is what researchers believe links periodontitis and RA. P. gingivalis, a common oral bacteria that is commonly associated with the development of gum disease, has the special ability to release a type of peptide that is often found in patients with RA.

So what does all of this mean?

Basically, researchers believe that a cause and effect relationship exists between gum disease and RA. When P. gingivalis builds up in the mouth, it causes gum tissue to become inflamed. This inflammation marks early stage gum disease called gingivitis. One of the most common symptoms of gingivitis is bleeding gums. Researchers believe the cracks that develop in gum tissue from gingivitis allow P. gingivalis to enter the bloodstream where it can move to other parts of the body, such as the joints. Once embedded in the joint, P. gingivalis can cause the same type of inflammation that causes RA to develop.

Conversely, since RA and periodontitis share so many similarities on a cellular and molecular level, researchers believe that the opposite can also occur – that patients with RA have a possibility of being at a greater risk for developing gum disease.

Protecting Your Oral Health

At the end of the day, protecting your oral health means doing everything possible to prevent the development of gum disease. As we have seen, gum disease not only increases your risk for serious oral health problems, it also increases your risk for a variety of other systemic health problems.

Fortunately, you can help to protect the health of your gums in three easy steps:

  • Brush twice a day
  • Floss daily
  • Schedule regular visits to see Dr. McLeod

That’s it. By practicing a little preventative dental care, you can improve your chances of enjoying a healthy, great-looking smile for a lifetime.