According to an article published in Current Oral Health Reports, researchers are getting closer to understanding the underlying factors that connect rheumatoid arthritis and periodontal disease.
In the article entitled “Rheumatoid Arthritis and Periodontal Disease: A Rheumatologist’s Perspective,” researchers discussed recent findings surrounding the connection between rheumatoid arthritis and periodontal disease, including the hypothesis that there is a direct, potentially causal association between the two diseases.
The relationship between gum disease and rheumatoid arthritis has long been discussed as potentially etiological and causal, as the two conditions share common risk factors and immunological processes.
- Both are characterized by inflammatory markers, including Il-1, Il-6, TNFα
- Patients with rheumatoid arthritis are more likely to have periodontal disease and vice versa.
- “Patients with active RA demonstrate significantly increased frequency and severity of periodontal diseases as well as tooth and alveolar bone loss.”
- Bacteria from the mouth can translocate to the knee and have been found in patients with RA.
This article highlighted a lengthy discussion of a recently identified antibody system that seems to directly link the “shared pathogenesis” of the two chronic inflammatory conditions.
With the discovery that serum antibodies to citrullinated peptides (ACPA) are highly specific for RA and that Porphyromonas gingivalis, the major pathogen responsible for periodontitis (PD), contains the enzyme responsible for the citrullination of peptides, a plausible explanation for observations of increased incidence and severity of PD in RA patients and an appreciation of pathogenic similarities between the two conditions has emerged.
From a rheumatologist’s perspective, the paper continues, four main non-pharmacological measures might improve disease control in patients with rheumatoid arthritis:
- Fatty acid supplementation
- Smoking cessation
- Weight loss
- Evaluation and treatment of periodontal disease
Rheumatologists now recommend the evaluation and treatment of periodontal disease for all RA patients, a significant milestone in the oral-systemic health movement. Improved outcomes, healthier patients, and lower healthcare costs often result when care is coordinated between medical and dental professionals.
As the study authors noted, this greater understanding of the PD-RA link will hopefully change the conversation from treatment to prevention.
Sources: Rheumatoid Arthritis and Periodontal Disease: A Rheumatologist’s Perspective
Re-posted with permission from the OSH News Network.
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Oral Cancer and Autoimmune Disorders