Brush, floss, get regular check-ups - it could help lower your risk of inflammatory diseases like rheumatoid arthritis. [ Photo: Bigstock]

Gum disease link to rheumatoid arthritis

21 June, 2018

Natural Health News — Increased levels of gum disease, and disease-causing bacteria, may raise your risk of developing rheumatoid arthritis (RA).

“It has been shown that RA-associated antibodies, such as anti-citrullinated protein antibodies, are present well before any evidence of joint disease. This suggests they originate from a site outside of the joints,” said study author Dr Kulveer Mankia of Leeds Institute of Rheumatic and Muscoskeletal Medicine and the Leeds Biomedical Research Centre.

“Our study is the first to describe clinical periodontal disease and the relative abundance of periodontal bacteria in these at-risk individuals. Our results support the hypothesis that local inflammation at mucosal surfaces, such as the gums in this case, may provide the primary trigger for the systemic autoimmunity seen in RA.”

Mankia presented the results of his work at the recent Annual European Congress of Rheumatology (EULAR 2018).

Quick summary

» Gum disease is a known risk factor for chronic inflammatory diseases such as diabetes and cardiovascular disease, and there is also previous research to connect it with and rheumatoid arthritis and even cancer.

» In this study individuals at risk of developing rheumatoid arthritis were twice as likely to have higher levels of clinical gum disease than those not at risk.

» A strict regimen of good dental care could be a key factor in of disease prevention.

Gum disease a consistent risk factor

The study included 48 at-risk individuals. Their level of risk was determined by the for anti-citrullinated protein antibodies, musculoskeletal symptoms but no clinical synovitis (inflammation of the synovial membrane). It also included 26 patients with RA and 32 healthy controls. The three groups were balanced for age, gender and smoking.

In results from the study, dentists diagnosed clinical gum disease in significantly more at-risk individuals than in healthy controls (73% vs. 38%). In addition, measurements of pocket depth, bleeding on probing, periodontal disease, and active periodontal disease, were all significantly greater in the at-risk individuals compared to controls. Even in non-smokers, periodontal disease and active peridontal disease were more prevalent in at-risk individuals compared to controls.

Another step towards prevention

Rheumatoid arthritis is a chronic inflammatory disease that affects a person’s joints, causing pain and disability. It can also affect internal organs. Rheumatoid arthritis is more common in older people, but there is also a high prevalence in young adults, adolescents and even children, and it affects women more frequently than men.

The prevalence of gum disease is increased in patients with RA and could be a key initiator of RA-related autoimmunity. This is because autoimmunity in RA is characterised by an antibody response to citrullinated proteins and the oral bacterium Porphyromonas gingivalis (Pg) is the only human pathogen known to be involved in the generation citrullinated proteins.

Gum disease is a known risk factor for chronic inflammatory diseases such as diabetes and cardiovascular disease, and there is also previous research to connect it with and rheumatoid arthritis. It has also recently been linked to a higher risk of cancer.  This data adds to what we know about the interactions between what are often considered separate parts of the body and body systems and the importance of whole body health.

“We welcome these data in presenting concepts that may enhance clinical understanding of the key initiators of rheumatoid arthritis,” said Professor Robert Landewé, Chairperson of the Scientific Programme Committee, EULAR. “This is an essential step towards the ultimate goal of disease prevention.”