Gum disease four times as common in rheumatoid arthritis patients

August 8, 2012

Gum disease is not only four times as common among patients with the autoimmune disease rheumatoid arthritis as it is among their healthy peers, but it also tends to be more severe, indicates a small study published online in the Annals of the Rheumatic Diseases.

The researchers base their findings on 91 adults with confirmed rheumatoid arthritis (RA) and a comparison group of 93 healthy people, matched for age and sex.

All participants were non-smokers, as smoking is a known risk factor for rheumatoid arthritis. And it is strongly associated with the production of antibodies, indicative of a systemic reaction to a person's own proteins (ACPAs), and which often predates the development of rheumatoid arthritis by several years.

And none had been treated with arthritis drugs known as disease modifying drugs, or DMARD, for short.

Disease activity was quantified using a specific score and by measuring levels of . And the extent of was assessed by quizzing participants on their symptoms.

These included swollen and , sensitive teeth, loose teeth, and a history of caused by gum disease. How far the gum had receded from the surface of the tooth, known as pocketing, was also measured using a probe.

Almost two thirds of patients (just under 65%) with rheumatoid arthritis had evidence of gum disease, compared with just over one in four (28%) of their healthy peers.

Overall, patients with rheumatoid arthritis were four times as likely to have gum disease. And their gum disease also tended to be more severe.

The depth of pocketing was also significantly greater among those with rheumatoid arthritis and especially among those who tested positive for ACPA, compared with those in the healthy comparison group.

Those who tested positive for ACPA had had their rheumatoid arthritis for longer, had higher levels of disease activity, and higher levels of inflammatory markers than those who tested negative.

Porphyromonas gingivalis is one of the main bacteria behind gum disease, and it is also the only organism known to produce an enzyme capable of generating ACPA in gum tissue.

Even those with rheumatoid arthritis, but without serious gum disease, as measured by pocketing, had symptoms, such as bleeding and swollen gums and sensitive teeth, but tooth loss was seen only in those with serious gum disease.

But mild gum disease in patients with rheumatoid arthritis may become more serious, and include testing positive for ACPA, suggest the authors. Published research indicates that ACPA antibody levels increase the longer a person has had rheumatoid arthritis.

"[Gum disease] is more common and severe in patients than in healthy controls...and could be a potential environmental trigger in the [development] and also in the maintenance of systemic inflammation in [the disease]," they conclude.

Explore further: Young women with rheumatoid arthritis at more risk for broken bones

Related Stories

Young women with rheumatoid arthritis at more risk for broken bones

November 6, 2011
Women under 50 with rheumatoid arthritis are at greater risk of breaking bones than women without the condition, according to a Mayo Clinic study being presented at the American College of Rheumatology annual scientific ...

Lower GI problems plague many with rheumatoid arthritis

April 3, 2012
Add lower gastrointestinal (GI) problems such as ulcers, bleeding and perforations to the list of serious complications facing many rheumatoid arthritis patients. They are at greater risk for GI problems and gastrointestinal-related ...

Recommended for you

Fluid in the knee holds clues for why osteoarthritis is more common in females

June 26, 2017
Researchers have more evidence that males and females are different, this time in the fluid that helps protect the cartilage in their knee joints.

Biologics before triple therapy not cost effective for rheumatoid arthritis

May 29, 2017
Stepping up to biologic therapy when methotrexate monotherapy fails offers minimal incremental benefit over using a combination of drugs known as triple therapy, yet incurs large costs for treating rheumatoid arthritis (RA). ...

Drug for refractory psoriatic arthritis shows promise in clinical trial

May 24, 2017
In a pivotal phase-3 clinical trial led by a Stanford University School of Medicine investigator, patients with psoriatic arthritis for whom standard-of-care pharmaceutical treatments have provided no lasting relief experienced ...

Cross-species links identified for osteoarthritis

May 17, 2017
New research from the University of Liverpool, published today in the journal npj Systems Biology and Applications, has identified 'cell messages' that could help identify the early stages of osteoarthritis (OA).

Osteoarthritis could be prevented with good diet and exercise

May 12, 2017
Osteoarthritis can potentially be prevented with a good diet and regular exercise, a new expert review published in the Nature Reviews Rheumatology reports.

Rodents with trouble walking reveal potential treatment approach for most common joint disease

May 11, 2017
Maintaining the supply of a molecule that helps to nourish cartilage prevented osteoarthritis in animal models of the disease, according to a report published in Nature Communications online May 11.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.