Rheumatoid arthritis (RA) is a systemic autoimmune disease which causes inflamed and stiff joints, severe pain, fatigue, and other moderate to severe symptoms. It’s estimated that 1.5 million in the United States suffer from this debilitating disease responsible for deformed joints and bone erosion.
Doctors once thought that periodontal disease was a result of RA due to severe pain in the patient’s hands inhibiting them from practicing proper oral hygiene. They also surmised that the medications used to treat RA might affect the body’s ability to fight harmful bacteria in the mouth. However, the correlation between the two seems more complicated than hand discomfort or effects of medications as research has also shown a genetic link between the two.
In general, periodontal disease seems to be a key indicator of the presence of many chronic diseases such as heart disease, diabetes, kidney disease, and some cancers. Inflammation and the body’s response are the key factors in these diseases. As studies continue and there’s a better understanding as to what causes RA, improved treatment options and perhaps preventative steps can be taken to fight this crippling disease.
The bottom line is that clinicians must be aware of RA and its relationship to periodontal disease. Patients with RA must be given proper hygiene instruction and any special aids (Power Brushes, Oral irrigators, mouth rinses, etc.) to help them practice proper oral hygiene. They should also be placed on a three-month recare schedule to keep the inflammation under control. Working together will assist in protecting patients from the oral effects of RA.