Treating Gum Disease to Fight Pain

Photo: Fingers swollen due to arthritis

Cleaning teeth might help
against rheumatic pain and
swollen joints; © SXC

This is not the first time that gum disease and rheumatoid arthritis have been linked. According to one of the researchers conducting the study, Ali Askari, "From way back, rheumatologists and other clinicians have been perplexed by the myth that gum disease may have a big role in causing systematic disease." He added that historically teeth were pulled or antibiotics given for treatment of rheumatoid arthritis, which actually treated the periodontitis. The patients got better.

Nabil Bissada of the research team notes that gum disease tends to be prevalent in rheumatoid arthritis patients. Both inflammatory diseases share similarities in the progression of the disease over time. In both diseases, the soft and hard tissues are destroyed from inflammation caused by toxins from bacterial infection.

One toxin from the inflamed areas called tumour neurosis factor-alpha (TNF-α) is a marker present in the blood when inflammation is present in the body. TNF-α can initiate new infections or aggravate sites where inflammation already exists.

The researchers studied 40 patients with moderate to severe periodontal disease and a severe form of rheumatoid arthritis. The study's participants were divided into four groups. Two groups of patients were receiving a new group of anti-TNF-α drugs that block the production of TNF-α at inflamed rheumatoid arthritis sites. Two groups were not on this new medication. Half of group of the participant on the medication and half not receiving the new drug received a standard nonsurgical form of periodontal treatment to clean and remove the infection from the bones and tissues in the gum areas. The other half of those studied did not receive the treatment until after completion of the study.

After receiving treatment for the gum disease, improvement in rheumatoid arthritis symptoms was seen in patients who did and did not receive the anti-TNF-α medications, which block the production of TNF-α that aggravate or can cause inflammation. Patients on the TNF- α inhibitors showed even greater improvements over those not receiving the drugs.

MEDICA.de; Source: Case Western Reserve University