“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,” says Nabil Bissada, DDS, chairman of the department of periodontics at the Case Western Reserve University School of Dental Medicine. “It gives us new intervention.”
The study by Bissada and colleagues is published in the Journal of Periodontology.
Gum Disease and Rheumatoid Arthritis
Bissada, Ali Askari, MD, chairman of the department of rheumatology at University Hospitals in Cleveland, and colleagues studied 40 people with moderate to severe rheumatoid arthritis as well as severe periodontal disease.
Half the participants received nonsurgical therapy for their severe periodontal disease and instructions on good oral hygiene. The other half received no periodontal therapy. All the participants were taking traditional DMARDs for rheumatoid arthritis such as methotrexate, Plaquenil, Arava, and Azulfidine, and half were also taking a biologic therapy such as Enbrel, Humira, or Remicade.
After six weeks, the researchers noted improvement in disease severity and level of an inflammation marker in people who got periodontal therapy.
The study concludes that "Non-surgical periodontal therapy had a beneficial effect on signs and symptoms of RA, regardless of the medications used to treat this condition."
Good Gums, Good Health
“From way back, rheumatologists and other clinicians have been perplexed by the myth that gum disease may have a big role in causing systematic disease,” he says in a news release.
Askari says the results of the study should prompt rheumatologists to encourage their patients to be aware of the link between gum disease and rheumatoid arthritis. Gum disease, he adds, tends to be common in people with rheumatoid arthritis.
Bissada says: “Again, we are seeing another link where good oral health improves the overall health of an individual.”