Oral Health + Arthritis

In the last several years, there has been a focus on the association of oral health and the connection with arthritis and autoimmune diseases. There is a link between gum and mouth inflammation and the body’s overall health. Mouth bacteria can enter the circulatory system and mouth inflammation can exacerbate cardiovascular disease, pulmonary, and kidney diseases.  Sometimes a dentist may be the first practitioner to identify a patient with autoimmune disease! 👩🏽‍⚕️

🦷 Oral ulcers and gingival bleeding can be seen in lupus.  Approximately 40-45% of patients have mouth sores which is a common symptom of lupus.  Usually, the ulcers are painless but can be present on the gums, lips, and roof of the mouth. 

🦷 In Sjogren’s syndrome, the salivary glands are affected, and the patient may suffer from excessive mouth dryness and decreased saliva production (xerostomia).

🦷 Because of excessive dry mouth symptoms, dental caries, plaque accumulation, and tooth decay can occur causing the destruction of enamel and dentin. A decrease in saliva flow can allow for the development of opportunistic infections like Candidiasis.

🦷 Worse periodontal disease has also been seen in RA patients characterized by bleeding, deep pockets surrounding the tooth, recessions of the gums, tooth loosening, and ‘friable gums”. Some studies have observed periodontal disease severity correlating with RA disease activity

🦷 In RA, a specific oral bacteria Porphyromonas gingivitis can trigger a response of the immune system (activate PAD enzyme) that can result in the production of creating specific autoantibodies called citrullinated peptides/CCP antibodies seen in aggressive RA.

🦷 Arthritis in patients is known to possibly cause jaw pain and teeth grinding. Temporomandibular joint disease can exist with systemic Sclerosis, RA, lupus. The TM joint can also be affected in Osteoarthritis.

🦷 Painful oral lesions can be the first sign of Bechet syndrome, an autoimmune multisystemic disease seen in younger individuals especially of Mediterranean, Turkish and Asian descent that is also characterized by genital ulcers, eye inflammation and vascular involvement. The ulcers can appear in cycles at the lips, soft palate, inside the mouth and tongue.

🦷 Pemphigus Vulgaris is another autoimmune condition that may cause blistering of the mouth.

It is extremely important for patients with autoimmune diseases to maintain good oral hygiene and go  for regular dental checkup!

Flossing and brushing frequently, limiting candy and sweets is essential to proper dental hygiene.

A dentist may also recommend a specific mouthwash or oral rinse, mouth moisturizers or medications that can stimulate saliva flow. 

Find a good dentist that will work with you to stay on top of your oral health!

So help that person in your life with arthritis schedule an immediate dental check-up if that individuals experience mouth or tooth pain.