Arthritis, particularly rheumatoid arthritis (RA), is a systemic inflammatory disease affecting millions of people. While commonly associated with painful, swollen joints in the hands, wrists, and knees, this chronic condition is not confined to the limbs. The inflammation that defines arthritis can travel throughout the body, significantly impacting structures of the mouth. Arthritis affects your teeth and gums, establishing a clear link between whole-body inflammation and oral health.
The Shared Inflammatory Pathway
The connection between arthritis and oral health is rooted in chronic inflammation. In RA, the immune system mistakenly attacks the body’s own tissues, releasing inflammatory mediators, such as cytokines, into the bloodstream. These signaling proteins cause inflammation and tissue destruction in the joints, but they circulate systemically, affecting other areas of the body.
The oral cavity is not isolated from this systemic inflammatory state. The same destructive mediators that damage joint cartilage can reach the tissues supporting the teeth. The inflammatory events in both RA and chronic periodontal disease share similarities, including dysregulated bone remodeling that leads to excessive bone resorption. This biological overlap creates an environment where inflammation in one part of the body can exacerbate inflammation in the other, establishing a bidirectional relationship.
Arthritis Effects on the Jaw Joint
One of the most direct impacts of arthritis on the oral structure is felt in the temporomandibular joint (TMJ). The TMJ acts as a hinge connecting the jawbone to the skull and is affected in a high percentage of RA patients. Inflammation within the TMJ can cause pain, swelling, and a reduction in the range of motion, making basic actions like chewing and speaking difficult.
Over time, chronic inflammation can lead to the deterioration of the joint cartilage and underlying bone structures. This bone erosion can result in changes to the way the upper and lower teeth align, a condition known as malocclusion. Symptoms often include a grating or clicking sensation, called crepitus, and stiffness that is frequently worse in the morning.
Inflammation and Gum Disease
The systemic inflammation associated with arthritis, particularly RA, has a significant link with chronic periodontal disease, or periodontitis. Individuals with RA have a higher prevalence and greater severity of periodontitis compared to the general population. This gum disease involves the destruction of the soft tissues and alveolar bone that anchor the teeth, potentially leading to tooth loss.
The presence of certain bacteria, such as Porphyromonas gingivalis, common in periodontitis, may influence RA development by triggering an autoimmune response. Furthermore, the physical limitations caused by arthritis can complicate the maintenance of effective oral hygiene. Joint pain and stiffness in the hands can make it challenging to hold a toothbrush or dental floss properly, accelerating the progression of gum disease. The systemic inflammation then exacerbates the local inflammation in the gums, creating a cycle of worsening disease in both areas.
Collaborative Care for Oral Health
Managing oral health when living with arthritis requires a proactive and coordinated approach between medical and dental professionals. Regular communication between a rheumatologist and a dentist is important for ensuring that care plans account for the systemic nature of the disease. This includes informing the dentist about the specific medications being used to treat the arthritis, as some can have oral side effects.
Many common arthritis medications, including immunosuppressants and some anti-inflammatories, can cause dry mouth, or xerostomia, which significantly increases the risk of cavities and oral infections. Using adaptive tools can help overcome the dexterity challenges that make daily oral care difficult. Electric toothbrushes with larger handles or floss picks can reduce the strain on stiff or painful joints, making thorough cleaning more achievable.