Key Points
- The Johns Hopkins Arthritis Center conducted a study to determine the presence of gum disease in patients who have Rheumatoid Arthritis (RA).
- Oral health exams were performed on patients who have RA and healthy volunteers for comparison. Data was collected from 100 RA patients and 40 healthy volunteers.
- 70% of the RA patients have gum disease with 30% having severe gum disease, while the population norm for gum disease is 35% with 5% having severe gum disease.
- Severe gum disease can be present in the early stages of RA.
- For best care with RA and oral health, patients should get complete oral health exams regularly and work with both their dentist and treating rheumatologist.
Dental Health and Rheumatoid Arthritis Research
Dr. Clifton Bingham III, director of the Johns Hopkins Arthritis center, and Malini Moni, BDS a post-doctoral research fellow investigated the presence of gum disease in patients who have rheumatoid arthritis (RA). During their research, over 300 complete oral health and rheumatological exams were done on patients who have RA. Along with the oral health and rheumatological exams, patients were given a questionnaire to complete. This questionnaire included detailed information about medical and dental history to give a full picture of the patients overall health.
The Research Process
A complete oral health exam includes looking at the number of teeth a patient has, if there is any gum inflammation, bleeding, or recession. The base of the teeth are also examined to see if there is any sign of bone loss or risk of tooth loss.
The rheumatological exam includes examining the joints and looking at the bloodwork for each patient to determine how severe their RA is. Patients were also tested for dry eyes, and dry mouth.
To understand whether gum disease is different in patients who have RA, healthy volunteers had a complete oral exam for comparison.
Results and Findings
The data collected from 100 RA patients and 40 healthy volunteers was compared and analyzed. The results show that 70% of RA patients in this study had at least moderate gum disease, 30% had severe gum disease. In the general population, 35% have gum disease, with 5% of those having severe gum disease. The higher rates and more severe gum disease in RA were not explained by other risk factors for gum disease like age or smoking.
The study found that even in the early stages of RA, gum disease and even severe gum disease was present. Some of the indicators of gum inflammation were less in people receiving biological RA therapy.
This study showed that gum disease was common and often severe in patients who have RA. Additional studies are now being done to evaluate how treatment of RA using biologic medications may affect RA and oral health and how markers of inflammation from fluid around the teeth and in saliva may give us information about RA. There are also studies taking place in the lab to understand whether exposure to bacteria in the mouth may be related to the development of RA or may make it more severe.
What does this mean for you?
It is important for all patients living with RA to be aware of your oral health. RA patients should get complete oral exams regularly at their dentist and should let the dentist know they have RA. Patients should let their rheumatologist know if they have any new dental problems.
TO improve overall oral health, some things to avoid are cigarette smoking, and chewing tobacco. Make sure to brush with a fluoride toothpaste, floss regularly and consider using a fluoride rinse. If arthritis affects your wrists or hands or if your grip is poor buy a battery-powered toothbrush with a large handle. If you have problems with dry mouth, let your doctor and dentist know as there may be medications and other ways to help with this symptom as well.
