For years, rheumatoid arthritis and periodontal disease have been linked through studies. But recent studies have shown that the two may be even closer linked than what was originally thought. The loss of teeth is considered a marker for periodontal disease so research into the two have been bolstered by the idea that the more teeth lost, the greater the risk a patient has of rheumatoid arthritis.
A study that was presented at the 2012 European Congress of Rheumatology in Berlin studied 636 patients that had early arthritis. Of this group, 24.2 percent had 10 or fewer teeth, 16.1 percent had between 11 and 20 teeth, 36.3 percent had between 21 and 27 teeth, and 23.3 percent at 28 or more teeth. To put that into perspective, a full set of adult teeth, including wisdom teeth, consists of 32 teeth.
Six months later, the participants were brought back for a follow up exam to see what response the patients had to treatment they were given. 52 percent of the patients had a good response to the treatment, 32 percent had a moderate response to the treatment, and 16 percent had no response to treatment. Researchers found that the worst prognosis occurred with those that had the fewest teeth.
To find the degree of which the loss of teeth could affect the arthritis, they studied the erythrocyte sedimentation rate of the patients. Those that had 10 or fewer teeth were shown to have more severe arthritis as they had a significantly greater erythrocyte sedimentation rate. They also showed to have higher tender and swollen joint counts and a higher Degree Activity Score.
At the same congress in Berlin, there was a separate but similar study by Italian researchers which studied the relationship between periodontal disease and swollen joints. In a group of 366 first-degree relatives of patients with rheumatoid arthritis, they found tooth loss to be associated with joint symptoms putting those relatives at risk of rheumatoid arthritis themselves. Results of the study found that those with swollen joints had an average of 26 teeth while those with non-swollen teeth had an average of 29 teeth. These results told the researchers that those that had fewer teeth were at a greater risk of joint inflammation. The study also found that those with less than 20 teeth were eight times more likely to have at least one swollen joint when compared to those with a full set of 32 teeth.
While these recent studies have advanced the knowledge of the relationship between periodontal disease and rheumatoid arthritis, they certainly are not the first studies that have connected the two. Between 1987 and 1998, 6,616 men and women underwent medical exams and between 1996 and 1998, underwent an assessment for periodontal disease in an attempt to learn more about the relationship. The study found that those with moderate or severe periodontitis were more than twice as likely to have rheumatoid arthritis than those that had little or no periodontitis.
The reason why this research started in the first place was from an observation that patients of rheumatoid arthritis also tended to have periodontal disease. Likewise, patients that had periodontal disease also tended to have rheumatoid arthritis. Initially, it was presumed by many doctors that it was rheumatoid arthritis that caused periodontal disease because the stiff and painful hands made it difficult to perform oral hygiene tasks. They also assumed that the drugs used to treat rheumatoid arthritis made it difficult for the body to fight the harmful bacteria in the mouth as it suppressed the immune system.
German researchers disputed these assumptions in 2008 by examining the oral hygiene of 57 patients with rheumatoid arthritis and a healthy controlled group of 52. Their research found that neither of the two were the cause of the other condition. Earlier this year, an Indian study used 91 periodontal disease patients with rheumatoid arthritis and 93 periodontal disease patients without rheumatoid arthritis. None of the patients had taken any disease-modifying antirheumatic drugs and, because of this, the drugs could not be blamed for suppressing the immune system.
It’s still unknown what the cause and effect are the connects these two conditions but it could be genetic. A recent Israeli study that was published in the Journal of Periodontology found that eight out of 10 patients that had rapidly progressive periodontitis had the genetic type HLA-DR4, something that often occurs in those with rheumatoid arthritis.
For nearly 30 years, researchers have been finding links between periodontal disease and rheumatoid arthritis. While it’s still not known exactly what the cause and effect are that allows the two to be linked, overwhelming evidence has shown that those with one could very well have the other. If you have signs of periodontal disease, come to Vero Implants and Periodontics for treatment.