Rheumatoid Arthritis: NHS on common signs and symptoms
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Poor oral health may have more of a devastating health consequence than previously thought. In fact, it’s been reported that gum disease symptoms are associated with increasing arthritis activity with evidence finding patients with more bleeding and swelling having higher levels of rheumatoid arthritis disease activity. What is the link?
Researchers have long speculated that autoimmune diseases such as rheumatoid arthritis (RA) are possibly triggered or caused by microorganisms.
Links between periodontal disease, changes in the oral and intestinal microbiome and RA have been known, but what exactly links them all has yet to be discovered.
Several studies seem to show that oral microbes may play a role in the development of RA.
One study highlighted three types of anaerobic bacteria occurring in the oral cavity that have been identified in joint fluid from people with RA.
Another analysis has shown that antibodies for certain types of bacteria are associated with periodontal disease and may play a role in the development of RA.
RA researchers have explored the possible link between early rheumatoid arthritis (ERA) and changes in their oral and intestinal microbiota.
It has been found that those with ERA have abnormal levels of certain bacteria in the mucus which lines the mouth and intestines.
Researchers also unveiled they were more likely than other people to have periodontal disease, or gum disease.
The study which was published in Arthritis & Rheumatology analysed the microbial populations and periodontal conditions of people with ERA, those at risk of RA and a control group of people without these conditions for comparison.
Another 2012 study reported that 65 percent of RA patients had gum disease compared with just 28 percent of patients without RA.
It was found that RA patients were four times more likely to have gum disease than their RA-free counterparts and their gum disease tended to be more severe.
Commenting on the study Professor Alan Silman, then Medical Director of Arthritis Research UK, said: “We have known for some time people with RA have an increased risk of periodontal disease, it could be that a person’s genetic make-up puts them at risk of developing both conditions.
“People with RA and the doctors treating the disease need to be vigilant for early signs of gum disease to prevent serious infection.”
The National Rheumatoid Arthritis Society reported:
- Porphyromonas gingivalis (P. gingivalis), one of the main bacteria responsible for gum disease can lead to earlier onset, faster progression and greater severity of RA, including increased damage to bone and cartilage.
- Concentration of antibodies against P. gingivalis is increased before the onset of rheumatoid arthritis symptoms.
- Gum disease is established and often more severe in patients with RA and characteristics of gum disease are similar in patients with early and established RA.
- Self-reported gum bleeding and swelling remained significantly associated with higher RA disease activity scores.
- Gum disease symptoms are associated with increasing RA activity; patients with more bleeding and swelling tend to have higher levels of RA disease activity.
Symptoms of periodontal disease include:
- Gums which are pulling away from teeth
- Teeth appearing longer as gums recede
- Sensitivity from hot or cold foods/drinks
- Bad breath
- Loose teeth that can make eating difficult
- Teeth may tilt, rotate or drift apart
- Gum abscesses can develop when pus builds up around the gums.
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