Study should prompt rheumatologists to encourage
patients to be aware of link between periodontal disease and rheumatoid
arthritis
May 28, 2009 - Here's one more reason senior
citizens should keep their teeth healthy. People, who suffer from gum
disease and also have a severe form of rheumatoid arthritis, reduced
their arthritic pain, number of swollen joints and the degree of morning
stiffness when they cured their dental problems, according to an article
in the Journal of Periodontology.
Researchers from the Case Western Reserve
University School of Dental Medicine and University Hospitals of
Cleveland reported on this new intervention for arthritis.
"It was exciting to find that if we eliminated the
infection and inflammation in the gums, then patients with a severe kind
of active rheumatoid arthritis reported improvement on the signs and
symptoms of that disease," said Nabil Bissada, D.D.S., chair of the
department of periodontics at the dental school.
"It gives us a new intervention," adds Bissada.
This is not the first time that gum disease and
rheumatoid arthritis have been linked. According to another researcher
in the study, Ali Askari, M.D., chair of the department of rheumatology
at University Hospitals,
"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.
Askari and Bissada are part of a team of
researchers that studied 40 patients with moderate to severe periodontal
disease and a severe form of rheumatoid arthritis.
The study results should prompt rheumatologists to
encourage their patients to be aware of the link between periodontal
disease and rheumatoid arthritis, says Askari.
Bissada 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 tumor
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 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.
"I'm optimistic that someday the biologic agents
that we use successfully in treatment of rheumatoid arthritis will lead
to improvement of periodontitis and would be available for use and
treatment of this perplexing problem," says Askari.
"Again we are seeing another link where good oral
health improves the overall health of an individual," says Bissada, who
adds that studies have linked gum disease to premature births, heart
disease and diabetes.
Background Information
Other researchers contributing to findings in the
article, "Periodontal Therapy Reduces the Severity of Active Rheumatoid
Arthritis in Patients Treated with or Without Tumor Necrosis Factor
Inhibitors," were P. Ortiz, Yiping Han, Leena Palomo, and Ashok
Panneerselvam from Case Western Reserve University; and M.S. Al-Zahrani
from King Abdulaziz University.
Case Western Reserve University is among the
nation's leading research institutions. Founded in 1826 and shaped by
the unique merger of the Case Institute of Technology and Western
Reserve University, Case Western Reserve is distinguished by its
strengths in education, research, service, and experiential learning.
Located in Cleveland, Case Western Reserve offers nationally recognized
programs in the Arts and Sciences, Dental Medicine, Engineering, Law,
Management, Medicine, Nursing, and Social Work.
http://www.case.edu.
Keep up with the latest news for senior citizens, baby
boomers
May 28, 2009 - Here's one more reason senior
citizens should keep their teeth healthy. People, who suffer from gum
disease and also have a severe form of rheumatoid arthritis, reduced
their arthritic pain, number of swollen joints and the degree of morning
stiffness when they cured their dental problems, according to an article
in the Journal of Periodontology. 