Healthy teeth lower rheumatoid arthritis pain

Claudia Salwiczek, DTI

Sun. 31 May 2009

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LEIPZIG, Germany: People who suffer from gum disease and also have a severe form of rheumatoid arthritis can lower the chronic pain by keeping their teeth healthy. A research team from Case Western Reserve University School of Dental Medicine and University Hospitals of Cleveland suggest that both inflammatory diseases share similarities in the progression over time. In both diseases, the soft and hard tissues are destroyed from inflammation caused by toxins from bacterial infection.

"It was exciting to find that if we eliminated the infection and inflammation in the gums, then patients with a severe kind of active rheumatoid arthritis reported improvement on the signs and symptoms of that disease," said Dr Nabil Bissada, chair of the department of periodontics at the dental school. "It gives us a new intervention," Bissada added.

Conventionally teeth were pulled or antibiotics were given for treatment of rheumatoid arthritis, which actually treated the periodontitis. Dr Bissada and co-researcher Dr Ali Askari, chair of the department of rheumatology at University Hospitals studied 40 patients with moderate to severe periodontal disease and a severe form of rheumatoid arthritis.

They found that one toxin from the inflamed areas called tumour neurosis factor-alpha (TNF-a) is a marker present in the blood when inflammation is present in the body. TNF-a can initiate new infections or aggravate sites where inflammation already exists.

The study showed that after receiving treatment for the gum disease, improvement in rheumatoid arthritis symptoms was seen in patients who did and did not receive the anti-TNF-a medications which block the production of TNF-a that aggravate or can cause inflammation.

"I'm optimistic that someday the biologic agents that we use successfully in treatment of rheumatoid arthritis will lead to improvement of periodontitis and would be available for use and treatment of this perplexing problem," said Askari.

“Again we are seeing another link where good oral health improves the overall health of an individual,” said Bissada, who adds that studies have linked gum disease to premature births, heart disease and diabetes.

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