You may or may not know that there’s a link between oral health and overall health. The causal relationship between the two is not always clear – in some cases, poor oral health could lead to other health concerns, while in other cases, failing health could cause oral health issues. The point is that taking care of your oral health is a good place to start when it comes to reducing the potential for other health problems.

Of course, many people already experience health issues that could have a marked impact on their oral health. Diseases like diabetes, for example, put patients at higher risk for oral health concerns like gum disease, infections, and even tooth loss. Cancer treatments can cause dry mouth that increases risks for gum disease and tooth decay, as well.

If you suffer from rheumatoid arthritis (RA), a progressive disease characterized by joint inflammation, you might not be concerned about the potential risks to your oral health. After all, what does one have to do with the other?

As it turns out, the two are linked. Not only could oral health issues be an indicator of rheumatoid arthritis and predict the severity of the condition, but controlling oral health could actually help to alleviate symptoms of RA, according to studies. Here’s what you need to know.

The Chicken and the Egg

Does RA increase the risks for gum disease or does gum disease exacerbate the symptoms of RA? There have been several studies on the links between gum disease and RA, and there seems to be evidence for both sides of causal debate, but it could be a vicious cycle, whereby RA leads to gum disease, which then makes RA symptoms worse.

Either way, it’s important to understand the ramifications of coping with RA when it comes to your oral health, and vice versa. Let’s take a look at what recent studies have uncovered concerning RA and gum disease.

In June of 2008, the Journal of Periodontology published a German study which found that patients diagnosed with RA were eight times more likely than those without RA to develop gum disease. At the 2012 European Congress of Rheumatology, a study of 636 patients with early arthritis was presented, detailing the number of teeth patients had at the time of the study, with the following results:

– 10 or fewer teeth: 24.2%

– 11-20 teeth: 16.1%

– 21-27 teeth: 36.3%

– 28 or more teeth: 23.3%

This study did a follow-up after six months to determine the relative health of patients, all of whom underwent treatment for arthritis in the intervening months. The group with the fewest teeth (10 or less) had the worst prognosis, showing the most advancement of symptoms and the least response to treatment.

On the other side of the causality debate, a study from the University of Louisville in Kentucky published in PLoS Pathogens in September 2013 found that the presence of porphyromonas gingivalis (the bacterium that causes periodontal disease) can increase both the severity of RA symptoms and the speed at which the disease advances. Another study out of Sweden published in Arthritis & Rheumatology in March 2016 found that the presence of this bacterium could actually trigger the onset of RA symptoms in some patients predisposed to the disease.

One thing that all of these studies make clear is that there is a link between RA and gum disease, which means patients that have RA or have high risk of RA need to pay special attention to their oral hygiene and healthcare.

How to Protect Oral Health when Coping with RA

The best defense is a good offense when you have RA or other inflammatory diseases that could impact your oral health, or that could be exacerbated by oral health concerns. Practicing proper oral hygiene and scheduling regular visits for dental care are a must, and you should definitely avoid bad habits like tobacco use that are known to increase risks for gum disease, tooth decay, and other oral health problems.

You should also consult with your periodontist and your rheumatologist, ideally working together as a team to create a suitable plan for comprehensive care. The last thing you want is to suffer the difficulties of gum disease on top of coping with RA, and worse, aggravate your RA symptoms in the process. With proper planning and care, you can avoid the onset of gum disease and ensure the best chance to alleviate RA symptoms.