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

FAQs

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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 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.

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.

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.

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

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.

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.

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.

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.

“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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

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).

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Risk factors

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

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.

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.

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.

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.

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.