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Achy Joints? How Your Mouth Could Be The Culprit




Lots of people consider arthritis to be something that “just happens” as we age.


How many times have you seen an older family member groan as they sit or stand, rub their fingers or hands, or wince as they bend down to pick something up off the floor?


It’s so common that it does seem like something that’s just inevitable. Like our hair turns grey, we also get arthritic as we age.


But it turns out there are certain risk factors that make us more or less prone to developing arthritis.


For example, there's a strong connection between oral health and the severity of rheumatoid arthritis.


Let’s explore the different types of arthritis and the one risk factor for rheumatoid arthritis that’s largely in our control to prevent.


Because eliminating even just one risk factor for rheumatoid arthritis can lower your risk of having chronic pain for life.


First, What is Arthritis?

















Arthritis, in general, is swelling and inflammation of the joints, connective tissues, and tissue surrounding the joints.


You might be surprised to learn that there are over 100 types of arthritis! [2]


For the most part, we hear about these five main types of arthritis:


  1. Osteoarthritis

  2. Rheumatoid arthritis

  3. Psoriatic arthritis

  4. Gout

  5. Lupus



Of those five, the two most common types of arthritis are:


  1. Osteoarthritis

  2. Rheumatoid arthritis

Osteoarthritis
















Osteoarthritis is the gradual breakdown of cartilage between the bones. Cartilage is firm, but much softer than bone. Cartilage cushions the ends of bones, preventing them from rubbing against each other, and makes movement comfortable.


Imagine rubber sandals that protect the bottoms of your feet so they don’t rub on the ground when you walk. If you walk in those same sandals for years, eventually the rubber will wear thin enough that your foot would come into contact with the ground.


And the harder you are on those sandals, the faster they’ll wear down.


That’s the way cartilage breaks down after years of walking, running, carrying excess weight, etc. When the cartilage breaks down enough that your bone rubs against the adjacent bone, it hurts. That’s osteoarthritis (OA).


As far as we know, osteoarthritis is not linked to gum disease – it’s simply wear and tear on the joints.


Frankly, OA can happen to anyone as they age. Joints of patients who are overweight are forced to bear more stress. So obesity puts a person at higher risk for earlier onset of the disease.


The best way to prevent or slow the progression of osteoarthritis is to maintain a healthy weight that your joints were designed to support. [5]


While OA isn’t entirely preventable, since you do use your body on a daily basis, it can be slowed or lessened by taking good care of your body.


Healthy eating and staying strong through exercise are the best prevention for osteoarthritis.


Rheumatoid Arthritis

















Rheumatoid arthritis (RA) is a little different. It's a chronic inflammatory disease that isn't caused by wear and tear.


RA is an inflammatory condition of the joints – most commonly, hands, wrists, and ankles. [8]


We know inflammation has negative effects on the body. But what is inflammation and what causes it in the first place?


Inflammation is an immune response.


When there's a foreign invader in your body, like bad bacteria or a virus, your immune cells kick into action to get rid of it.


Inflammation is your immune system fighting something off.


Inflammation usually causes symptoms such as fever, redness, fatigue, and joint pain. Once the foreign invader has been cleared out, the inflammation goes away and you feel better.


But sometimes the immune system gets confused and tries to fight off something that's not a foreign invader.


Sometimes the immune system attacks the body it's meant to protect.


This is what’s happening in autoimmune diseases.


Rheumatoid arthritis is an autoimmune disease caused by the body turning on a protective immune system response – against itself.


Scientists still don't know exactly what causes the onset of an autoimmune disease, but there's solid evidence that the health of your gum tissue plays a role.


If you have high numbers of bad bacteria present in your oral cavity, you're at an increased risk for other health problems, including rheumatoid arthritis.


How Does Gum Inflammation Affect Rheumatoid Arthritis Patients?

















We're learning on a daily basis more and more about the interconnectedness of our body systems. The status of your gums is a big indicator of your overall health.


There are likely more answers to this question than we’re even currently aware of. But we do know that dental health plays a role in how severe RA can be in a patient.


There's one glaring common factor in both gum disease and rheumatoid arthritis – inflammation.


One known cause of inflammation is bad bacteria. When harmful bacteria are present in the mouth, they spread to other parts of your body.


But here’s the good news – oral bacteria is something we actually have relatively good control over! In other words, good oral hygiene plays an important role in keeping your entire body healthy.


Which Bacteria Are Associated With Gum Disease and Rheumatoid Arthritis?

















You’ve heard of the bad bacteria that get all the media attention; E.coli, MRSA, Staph.


You know if you’re infected with one of those guys, you’re pretty sick.


But there are loads of other bacteria.


Lots of good bacteria and also some bad bacteria.


There are a few bacteria that rheumatologists pay attention to (rheumatologists are doctors who specialize in diseases affecting joints, bones, and muscles). Those are:


  1. Porphyromonas gingivalis (P. gingivalis)

  2. Aggregatibacter actinomycetemcomitans (Aa)

  3. Prevotella copri (P. copri)


Dentists and dental hygienists are very familiar with P. gingivalis and Aa.


It's a well-known fact that these two specific types of bacteria are associated with gum disease.


And guess what?


P. gingivalis and Aa have also been linked to rheumatoid arthritis.


As a matter of fact, in a study published in Current Opinion in Rheumatology in 2019, arthritis was actually triggered in mice after they were infected with P. gingivalis.


Does that mean that P. gingivalis is the cause of rheumatoid arthritis?


We can’t say that definitively because there are likely several factors that contribute to a person developing arthritis.


But it’s worth taking notice because there's definitely a link. And we do know that it's one of the causes of severe periodontal disease (gum disease).


So, since we know P. gingivalis is associated with rheumatoid arthritis, and we know that it causes gum disease, doesn't it make sense to find out if you have that bacteria living in your mouth? And if you do, wouldn't it make sense to treat it where it's relatively easy to treat?


Disease control can start with the care of your teeth.


Good oral care doesn't simply prevent tooth decay and tooth loss, it also helps lower your risk for diseases like rheumatoid arthritis.


Patients report an improvement in their rheumatic diseases after taking care of their dental problems. [9]


What's more, recent studies also indicate that severe gum disease may increase a person's risk for cardiovascular disease, diabetes, and dementia.



One Piece of The Inflammation Puzzle You Can Control

















What if treating gum disease in its earliest stages – or better yet, preventing it entirely – could help prevent the onset of RA?


While you’ll read in large part the opinion that RA is not preventable and that there’s no known cause for it, there’s strong evidence that gum disease is linked to RA. [11]


Even if it’s not THE ONLY piece of the puzzle, the fact that THERE IS A LINK should make us take notice.


Because gum disease is entirely preventable!


And if you already have gum disease, it's treatable and manageable with periodontal therapy.


Regular dental exams and good dental care help you avoid suffering from severe inflammation (severe periodontitis) in your mouth.


Practicing good dental hygiene and keeping your mouth healthy are keys to making sure you stay healthy overall and lower your risk of suffering from rheumatoid arthritis.


How To Know If You Have Gum Disease


The best way to know if you have healthy gums or not is to have a dental check-up. A dentist or hygienist will diagnose your level of gum health with a quick and painless exam.


Getting your gums and teeth checked is easier than you might think!


Schedule an appointment today if you haven’t had a dental exam within the last six months.


Also, doing a saliva test in the privacy of your home can be a good place to start. Bristle Health offers kits that give you an overview of your oral microbiome that you can then share with your dentist and hygienist.


Your future self will thank you for catching a disease risk factor early!



THE TAKEAWAY: If you PREVENT gum disease, chances are, you’re also LOWERING YOUR RISK for the onset of rheumatoid arthritis later in life.



References:


1.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4495574/


2.https://www.cdc.gov/arthritis/basics/types.html


3.https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html


4.https://www.webmd.com/rheumatoid-arthritis/guide/most-common-arthritis-types


5. https://pubmed.ncbi.nlm.nih.gov/32533170/


6. https://www.hopkinsrheumatology.org/2017/01/gum-disease-linked-to-rheumatoid-arthritis/


7. https://pubmed.ncbi.nlm.nih.gov/31268867/


8.https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html#:~:text=RA%20mainly%20attacks%20the%20joints,causing%20damage%20to%20joint%20tissue.


9. https://www.sciencedaily.com/releases/2009/05/090528135252.htm


10. https://www.science.org/content/article/gut-bacteria-may-cause-rheumatoid-arthritis


11. https://pubmed.ncbi.nlm.nih.gov/29221594/



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