Rheumatoid arthritis and your teeth: what you need to know (2023)

The chronic autoimmune disease rheumatoid arthritis causes joint pain and inflammation. It can also lead to dental problems.

Rheumatoid Arthritis (RA)is a chronic autoimmune disease that most noticeably causes joint pain, swelling and inflammation. There are other less noticeable problems that can arise from RA, including effects on your teeth and oral health.

Your jaw, teeth, and other oral structures need a strong support system, and RA can allow for regular brushing and flossing.stronger.

Suremedicinesordinaryto cureRA - like other health conditions - can also lead todry mouthand cause other problems with the mouth and teeth. Although this may not occur often as a result of taking rheumatoid arthritis medications, consulting with your healthcare team can be an important way to determine potential side effects for any prescription or over-the-counter medications.

This article will explore some of the more common oral and dental problems that can occur in people with RA and what steps you can take.

The bone loss associated withRAit can definitely affect your oral health. RA is an auto-inflammatory disease that affects the entire body.

Although the changes may be most noticeable in your joints, where pain and inflammation are most severe, bone destruction and wear and tear can also occur in many other parts of your body.

Below are some of the main ways RA can cause problems for your oral health.

Periodontal disease

Periodontal diseasecan trigger RA in some people.

This is a chronic inflammatory disease caused by a film of bacteria that can develop on your teeth and gums. Ultimately, this bacterial growth leads to inflammation and tissue damage. Yoursrich in collagenTissues are at greater risk of damage from RA and periodontal disease.

(Video) Dental Health Tips for Rheumatoid Arthritis Patients

In RA, this loss can occur in:

  • cost
  • articular cartilage
  • tissues around your joints (periarticular tissues)

With periodontal disease, damage can occur:

  • the ridge of bone that holds your teeth together (alveolar bone)
  • the ligaments that hold your teeth in place (periodontal ligaments)
  • yoursgum

Temporomandibular joint (TMJ) problems.

Temporomandibular joint (TMJ) dysfunction.is a common problem in people with RA.

TMZ is used more than2000times a day for chewing and speaking. Between5% and 86%People with RA are thought to have discomfort in this joint.

One study found:

  • Eye45%people with RA who had TMJ problems had difficulty chewing.
  • Eye40%they had to make changes in their diet because of these chewing problems.
  • Eye30%he had pain when he ate.
  • Eye36%was on pain medication for TMJ related issues.

Dry mouth

Autoimmune conditions such as RA andSjögren's diseaseare also common causesproblems with the salivary glands.

Salivary gland problems that arisedry mouth— and eventually cause additional problems like tooth decay — happen around30% to 50%person with RA.

In addition to natural problems with the salivary glands that can lead to dry mouth, some medications used to treat RA and related conditions can cause dry mouth as a side effect.

Specific arthritis medications that can cause drying of the salivary glands in the mouth arenon-steroidal anti-inflammatory drugs (NSAIDs), including Celebrex.

Other drugs that may cause dry mouth but are not specific for RAinclude:

  • antihistamines
  • antidepressants
  • antipsychotics
  • blood pressure pills
  • diuretics
  • painkillers
  • sedatives

Is RA affecting your jaw?

(Video) Dental Health and Rheumatoid Arthritis

RA is a chronic disease in which your body attacks its own cells, causing damage and wear and tear over time to your bones, joints and other tissues.

RA can cause pain and inflammation, usually in more than one joint in your body — and it can be any joint. The TMJ is what moves your jawbone as you speak and chew. Problems in this joint can be painful and especially difficult to treat because there is nothing you can do to avoid using this area.

Although bony breakdown of the TMJ can be a problem, it is rare in adults whose inflammatory symptoms are well controlled.

There is also tooth decay that can occur in your jawbone due to the RA disease process as well as the medications used to treat RA.

A term related to drugsosteonecrosis of the jawIt was himfirst time usedto describe jaw damage from certain medications in 2014. It specifically describes damage to your jawbone that can occur when you use certain medications.

Teeth that have been extracted and replaced with dental implants require new bone growth for the implant to be successful. In people with RA or people taking certain medicines to treat RA, bone growth is slow or absent.

Somestudiesshow a higher failure rate of dental implants in people with rheumatoid arthritis or people being treated for RA compared to people without the disease. But having RA or Sjögren's doesn't mean you can't get dental implants. A dentist or rheumatologist can help guide you through the potential risks and benefits.

Can you have a tooth extracted if you have RA?

(Video) Rheumatoid Arthritis - All You Need To Know | Arthritis Action Webinar

Sometimes tooth extraction is necessary to treat oral health problems.

If you need a tooth extracted and you have RA, you may face some additional problemscomplications.

But depending on the reason you're pulling the tooth,these questionsmay not be a reason to avoid export. Delaying a tooth extraction that is necessary to treat things like an infection can cause you a host of other problems.

Talk to your dentist or healthcare professional about your individual reasons and risks for tooth extraction. RA and the drugs used to treat it are rarely a reason to delay or cancel a tooth extraction.

RA does not directly affect your teeth.

It is a disease that affects the cells that make up your bones, joints and connective tissues. This means that RA can affect your gums and overall dental health, but not your teeth.

Suremedicinesused to treat RA can cause problems for your teeth.

(Video) What do your teeth have to do with arthritis?

So-called medicinesdisease-modifying antirheumatic drugs (DMARDs)that suppress your immune system is the main treatment for RA.

While these drugs do a good job of reducing the pain and inflammation of RA, they can also increase the risk of infection and potentially cause bone loss.

All of these could contribute to a toothache, especially if it causes mouth infections to develop or teeth to loosen.

Pain is a big part of RA. Although some medications used to treat rheumatoid arthritis inflammation can reduce pain, they may also be prescribed for youNSAIDsor other pain relievers. These medications can treat many types of pain and should help with any dental pain you have, as well as RA.

If your only symptom is a toothache, it may not be caused by RA.

But if he is diagnosed with RA and begins to havetoothache, talk to your healthcare team or dentist. They may be able to rule out more complex causes of pain or infection, especially if you have RA and take medications that can suppress your immune system.

RA is a chronic disease that causes your body to attack its joints and bones. All joints and bones can be affected, including those in the jaw and mouth.

(Video) Rheumatoid Arthritis and Dental Health | What you need to know #DentalHealth

If you have RA, it's important to take steps to prevent infections and other forms of inflammation in your mouth with good dental hygiene. Removing a tooth or implant may be difficult because of RA and the slow bone growth associated with it, but your dentist or healthcare team can help you take steps to reduce your risk of complications.


Rheumatoid arthritis and your teeth: what you need to know? ›

In addition to general health complications, RA can cause you to develop serious oral conditions, such as: Gingivitis, a mild form of gum disease that causes swollen and tender gums. Periodontitis, an inflammatory condition affecting the bone and tissue supporting the teeth.

What do people with periodontitis and RA have in common? ›

But research shows that the two have certain bacteria in common. These germs – including P. gingivalis and Aggregatibacter actinomycetemcomitans (Aa) – can trigger both periodontal disease and the inflammation found in RA.

Can rheumatoid arthritis affect your jaw and teeth? ›

RA can affect the jaw, just as it can affect any other joint in the body, and it is estimated that in more than 17% of patients with RA, the jaw joint is affected.

What are the side effects of methotrexate on teeth? ›

Chemotherapy treatments – Chemotherapy medications, like methotrexate, can lead to inflammation of the inside lining of your mouth and result in tooth decay. Aspirin – Use of this popular over-the-counter medication can result in mouth sores and bleeding of the gums.

Are rheumatoid arthritis patients candidates for dental implants? ›

Although there isn't a cure, it can be managed with medications and lifestyle changes. While RA affects the joints, many people with the condition are still candidates for dental implants; however, every situation differs.

What are the dental problems with rheumatoid arthritis? ›

The effects of rheumatoid arthritis

In addition to general health complications, RA can cause you to develop serious oral conditions, such as: Gingivitis, a mild form of gum disease that causes swollen and tender gums. Periodontitis, an inflammatory condition affecting the bone and tissue supporting the teeth.

How does rheumatoid arthritis affect your teeth? ›

Due to the inflammatory nature of the disease, arthritis can also affect your dental health. Inflammation causes gum disease, the number one source of tooth decay and oral infections. If you have arthritis, you may be more likely to need a crown or a root canal.

What does RA jaw pain feel like? ›

The symptoms of RA in the jaw include : an aching jaw. pain, tenderness, or stiffness in the jaw joint. a grinding, creaking, or crunching sound, known as crepitation.

Can rheumatoid arthritis affect your face? ›

Arthritis can cause painful, swollen knees or fingers that are impossible to ignore. But other parts of the body, including the skin, eyes and lungs can also be affected.

How do you treat rheumatoid arthritis in the jaw? ›

Anti-inflammatory medications are commonly used to treat jaw pain from RA. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve (naproxen) and Advil (ibuprofen) help reduce swelling and jaw pain.

How long can you stay on methotrexate? ›

Many patients with rheumatoid arthritis have stayed on this drug for 20 years or more.

What is the most common complication of methotrexate? ›

GI problems such as nausea and vomiting are the most common side effects associated with methotrexate, affecting between 20% and 65% of rheumatoid arthritis (RA) patients who take the drug. Up to one-third develop mouth ulcers or sores. Many also complain of headaches, fatigue and an overall “blah” feeling.

What organ does methotrexate affect? ›

However, methotrexate can produce many unwanted side effects and can alter liver cells, leading to liver damage and cirrhosis.

What is end stage rheumatoid arthritis? ›

The end stage of RA means that most of the tissue that was formerly inflamed has been destroyed, and bone erosion has occurred. The affected joints stop functioning and patients experience pain and severe loss of mobility.

Is rheumatoid arthritis considered a disability? ›

Is Arthritis a Disability? Simply being diagnosed with rheumatoid arthritis does not qualify you for disability. However, if your ability to work is greatly affected or impaired by your condition, then with the proper documentation, you may be entitled to SSA disability benefits.

Can I have dental implants if I take methotrexate? ›

In addition, if you are using methotrexate, your jawbone may not be able to fuse with the implant because of this medicine. Long-term usage of this medication may reduce bone density and, ultimately, implant failure.

What is the most common complication of rheumatoid arthritis? ›

If you have rheumatoid arthritis, you're at a higher risk of developing cardiovascular disease (CVD). CVD is a general term that describes conditions affecting the heart or blood vessels, and it includes life-threatening problems such as heart attack and stroke.

What is the most common dental autoimmune disease? ›

Sjogren's Syndrome is one of the most common autoimmune diseases that affect dental health.

What is the most commonly affected in rheumatoid arthritis? ›

The joints most often affected by RA are in the hands, wrists, feet, ankles, knees, shoulders, and elbows. Symptoms may include joint pain, stiffness, and swelling; decreased and painful movement; bumps over small joints; and fatigue or fever.

What autoimmune diseases cause bad teeth? ›

Inflammation in the gums is linked to several different autoimmune disorders, including lupus, Crohn's disease, and scleroderma, among others. Gingivitis is a condition in which gums are inflamed and red; it's a precursor to gum disease.

Can rheumatoid arthritis affect your eyes? ›

More rarely, rheumatoid arthritis can cause inflammation in the white part (sclera) of your eyes, which can result in redness and pain. If you have rheumatoid arthritis and experience eye pain, vision changes or other eye problems, consult an ophthalmologist for an evaluation.

How do you know if you have inflammation in your jaw? ›

  1. Pain in the chewing muscles and/or jaw joint (most common symptom).
  2. Pain that spreads to the face or neck.
  3. Jaw stiffness.
  4. Limited movement or locking of the jaw.
  5. Painful clicking, popping, or grating in the jaw joint when opening or closing the mouth.
  6. Ringing in the ears, hearing loss, or dizziness.

Can you fix arthritis in your jaw? ›

Jaw rest, a soft diet, a bite splint, and medical therapy, including disease-modifying antirheumatic drugs (DMARDs) and simple analgesia, are the bedrock of initial treatment and will improve most symptoms in most patients.

How do you test for arthritis in the jaw? ›

Jaw bone and cartilage changes due to arthritis may be seen on imaging tests such as an X-ray, CT scan, or MRI. “Changes that can be visualized on imaging include condylar beaking or flattening [damage to the rounded end part of the bone], and decreased joint space,” Dr. Levi says.

How do I know if my rheumatoid arthritis is getting worse? ›

If you notice that you cannot move your joints as much or as easily as before, even if you don't have swelling or pain, your RA may be getting worse,” says Dr. Ghosh. Changes in the way joints look or function, which do not improve with changes in RA treatment, can be a sign of disease progression, says Dr. Wallace.

What is the sudden appearance or worsening of rheumatoid arthritis? ›

A:Flare. A flare is the sudden appearance, increase, or worsening of rheumatoid arthritis symptoms such as pain, inflammation, redness, warmth, or tenderness. Flares can last for days or weeks.

What kind of doctor treats arthritis of the jaw? ›

Your dentist might be the first person you talk to about TMJ pain, but a rheumatologist should also be involved if you have arthritis in other joints.

How do you get rid of inflammation in your jaw? ›

Use a hot or cold compress

Ice helps reduce swelling and pain, while heat can increase blood flow and relax your jaw muscles. Apply a hot or cold compress to your jaw for 15 to 20 minutes at a time using a light layer between the compress and your skin.

How do you exercise with rheumatoid arthritis in the jaw? ›

Keeping your tongue on the roof of your mouth, place one finger on your TMJ and another finger on your chin. Drop your lower jaw completely and back. For a variation of this exercise, place one finger on each TMJ as you completely drop your lower jaw and back. Do this exercise six times to complete one set.

What should you avoid while taking methotrexate? ›

You should not take methotrexate while taking antibiotics containing trimethoprim-sulfa (Bactrim®, Sulfatrim®, etc…). If you are prescribed one of these medications for an infection, do not take your methotrexate that week.

Is methotrexate a steroid or chemotherapy? ›

Methotrexate is a type of chemotherapy. It's a treatment for a number of different types of cancer.

What foods should you avoid while taking methotrexate? ›

There are no specific foods that you need to avoid while taking methotrexate. However, methotrexate may reduce your ability to fight infection, so it's best to avoid unpasteurised milk and soft cheeses. It's also best to avoid having too much caffeine, contained in coffee, tea, cola, energy drinks and chocolate.

What does methotrexate do to your brain? ›

Methotrexate is a mainstay of RA treatment and corticosteroids are sometimes used for short-term pain relief. Both may cause cognitive problems, mood changes and confusion.

What painkillers can I take with methotrexate? ›

You can usually carry on taking painkillers like paracetamol if needed, unless your doctor advises otherwise. Avoid taking non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin or ibuprofen, or medicines containing NSAIDs, such as over-the-counter cold medication, without first speaking to your doctor.

Why shouldn't you handle methotrexate? ›

May cause bone marrow, liver, lung, and kidney disease; deaths have been reported from methotrexate use. Periodic liver biopsies are recommended for people taking methotrexate long-term. Acute liver enzyme elevations have been seen. Regular monitoring is needed for bone marrow, lung, or kidney toxicity.

What can I take instead of methotrexate for RA? ›

Leflunomide (Arava®) Leflunomide is also an effective DMARD. Its efficacy is similar to methotrexate in terms of signs and symptoms, and is a viable alternative to patients who have failed or are intolerant to methotrexate. Leflunomide has been demonstrated to slow radiographic progression.

What are the signs that methotrexate is working? ›

What are the signs that methotrexate is working?
  • decreased pain.
  • fewer painful joints.
  • less morning stiffness.
  • less swelling in joints.
Sep 19, 2022

Can methotrexate affect your eyes? ›

Methotrexate-related ocular toxicities consist of peri-orbital edema, ocular pain, blurred vision, photophobia, conjunctivitis, blepharitis, decreased reflex tear secretion87 and non-arteritic ischemic optic neuropathy. The optic neuropathy has been linked to folate deficiency, either nutritional or genetic.

What is the most common cause of death in patients with rheumatoid arthritis? ›

Heart disease should be considered a serious cause for concern among people with RA, even those who've yet to reach middle age.

What is the average age of death for people with rheumatoid arthritis? ›

Rheumatoid Arthritis and Lifespan

In the study, the median survival rate for healthy adults was approximately 82 years while the median survival rate for people with RA was approximately 77 years.

What are the symptoms of the advanced stage of rheumatoid arthritis? ›

In end-stage RA, people may still experience pain, swelling, stiffness, and mobility loss. There may be lower muscle strength. The joints may experience destruction, and the bones may fuse (ankylosis).

What are you entitled to if you have rheumatoid arthritis? ›

Money and benefits

if you have a job but cannot work because of your condition, you're entitled to Statutory Sick Pay from your employer for up to 28 weeks. if you do not have a job and cannot work because of your condition, you may be entitled to Employment and Support Allowance.

Can you go on Social Security for rheumatoid arthritis? ›

If you have a physical impairment that limits your ability to perform your daily tasks and work to earn a living, you may qualify for Social Security disability benefits. Rheumatoid arthritis or osteoarthritis and disability benefits are certainly possible if the condition prevents you from working.

How much is Social Security disability for rheumatoid arthritis? ›

The average monthly SSDI benefits payment for arthritis is a lot less than the maximum—estimated to be $1,483 at January 2023. The SSA uses a method which is the same as that used for calculating retirement payments, although on average, disability benefit payments tend to work out to be less than retirement payments.

Should people with RA get dental implants? ›

Since RA can affect your mobility, your candidacy for dental implants will depend on how well you can brush and floss your teeth. If RA affects your hands, it can be difficult to hold a toothbrush or use dental floss, making you more likely to experience dental implant failure.

Who Cannot have dental implants? ›

People with gingivitis, periodontist or any other form of gum disease cannot have dental implants. This is because this condition destroys the gums and the bone beneath. As a result, too much bone loss leads to lack of sufficient bone for the implant to attach. Dentists often suggest treating gum diseases first.

Can a person with RA get dental implants? ›

If you have RA, don't be discouraged. You may still be a candidate for dental implants. Your dentist will perform a thorough consultation to create a personalized strategy to replace your missing teeth safely.

Is rheumatoid arthritis linked to periodontal disease? ›

Gum disease and RA

People with RA appear to face an increased risk of developing gum disease and are more likely to suffer from more severe symptoms. After diagnosis with RA people may notice more bleeding whilst brushing, gums receding and loss of teeth.

What is the interrelationship of periodontitis and rheumatoid arthritis? ›

RA and periodontitis are both common chronic inflammatory diseases, and may associate bidirectionally. The diseases show several similarities in their pathogenesis (20), i.e. inflammatory mediators, cytokines and proteolytic enzymes are largely similar, with a tissue degrading profile in the two conditions.

Does periodontitis cause rheumatoid arthritis? ›

Medical investigators have observed a clinical association between periodontal disease (gum diseases) and RA since the early 1900s, and over time, researchers have suspected that both diseases may be triggered by a common factor.

What autoimmune disease causes periodontitis? ›

Inflammation in the gums is linked to several different autoimmune disorders, including lupus, Crohn's disease, and scleroderma, among others. Gingivitis is a condition in which gums are inflamed and red; it's a precursor to gum disease.

What are two diseases that are linked to untreated periodontitis? ›

For example, periodontitis is linked with respiratory disease, rheumatoid arthritis, coronary artery disease, preterm birth and low birth weight, and problems controlling blood sugar in diabetes.

What virus is associated with rheumatoid arthritis? ›

Viruses may also play a role in triggering RA. According to the Cleveland Clinic, people with RA, on average, have higher levels of antibodies to the Epstein-Barr virus (which causes mononucleosis) than the general population. The Epstein-Barr virus isn't the only virus suspected as an infectious agent in RA.

What other diseases are rheumatoid arthritis related to? ›

Lupus and Scleroderma

The autoimmune diseases systemic lupus erythematosus and scleroderma are two separate conditions but often present with joint involvement that mimics rheumatoid arthritis.

What is the characteristic of most patients with rheumatoid arthritis? ›

Signs and symptoms of RA include: Pain or aching in more than one joint. Stiffness in more than one joint. Tenderness and swelling in more than one joint.

What is the most commonly associated factor in inflammatory periodontal disease? ›

Risk factors

Certain factors increase the risk for periodontal disease: Smoking. Diabetes. Poor oral hygiene.

What periodontal diseases are considered inflammatory diseases? ›

Periodontitis, a major inflammatory disease of the oral mucosa, is epidemiologically associated with other chronic inflammation-driven disorders, including cardio-metabolic, neurodegenerative and autoimmune diseases and cancer.

What is the side effect of periodontitis? ›

If you have untreated gum disease that develops into periodontitis, it can lead to further complications, such as:
  • gum abscesses (painful collections of pus)
  • receding gums.
  • loose teeth.
  • loss of teeth.
Feb 13, 2023

What virus causes periodontitis? ›

Tissue tropism of herpesviral infections may help explain the localized pattern of tissue destruction in periodontitis. Frequent reactivation of periodontal herpesviruses may account for the rapid periodontal breakdown in some patients even in the presence of relatively little dental plaque.

What health problems can periodontal disease cause? ›

Research has linked oral health problems such as periodontal or gum disease to many health conditions, including diabetes, heart and kidney disease, Alzheimer's, asthma, osteoporosis, and cancer.

What deficiency causes periodontitis? ›

Deficiency in vitamin D leads to reduced bone mineral density, osteoporosis, the progression of periodontal diseases and causes resorption to occur in the jawbone.

What cancers are associated with periodontal disease? ›

gingivalis and the Fusobacterium species have been found in esophageal cancer, colorectal carcinoma and pancreatic cancer. In a previously published paper, the positive association between periodontal diseases and non-Hodgkin lymphoma (NHL) has been demonstrated.

What autoimmune disease affects your teeth? ›

Sjogren's Syndrome is one of the most common autoimmune diseases that affect dental health. It is a disease that weakens the salivary glands, the glands that produce saliva. Saliva is an important part of fighting off infection and how your mouth functions.


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