Study Finds Gum Disease Linked to RA Risk

Effective periodontal treatment in Portland does more than just repair the damage done to a patient’s smile by gum disease. Treatment from Dr. Goldwyn also works to help lower a patient’s risk for developing the types of systemic health problems linked to gum disease, such as heart disease, diabetes, and arthritis.

Approximately 1.5 million people in the U.S. deal with rheumatoid arthritis (RA), an autoimmune disease that causes swelling in the joints, pain, and permanent damage to motor function and mobility.

Like many diseases, the earlier a patient has their RA diagnosed, the more likely they receive a positive treatment outcome, such as limiting joint damage and minimizing discomfort. Since early treatment intervention offers such positive results, researchers continue to look for new ways of diagnosing RA, especially during the initial stages of the disease.  

Unfortunately, researchers still don’t fully understand the mechanisms behind what causes RA to develop in the body. The main hypothesis though does point towards a combination of environmental factors and genetics.

In recent years, researchers have turned their attention towards exploring the connection between early rheumatoid arthritis (ERA), people who are at risk for developing RA, and changes that occur in their oral microbiome.

Early data shows that individuals with ERA and who are at risk of developing full blown RA have abnormal levels of certain types of oral bacteria. They also seem to have a higher risk for developing gum disease.

Additionally, some preliminary research even suggests that RA may start in the mouth.

Based on these data points, researchers at the Academic Centre for Dentistry of Amsterdam started a study to analyze the microbial population and periodontal conditions of patients with ERA, those at risk of developing RA, and a control group of participants without either condition.

The results of the study were published in the journal Arthritis & Rheumatology.

RA and the Oral Microbiome

Researchers have hypothesized that autoimmune diseases like RA are actually triggered or caused by microorganisms.

For decades, researchers have known that links exist between gum disease, changes in the oral microbiome, and RA.

Multiple studies have found that oral microbes – specifically anaerobic bacteria – may play a part in the development of RA.

One study from 2009 showed that three types of anaerobic bacteria found in the mouth have been identified in the joint fluid of patients with RA. Additional studies have found that antibodies for certain types of anaerobic bacteria linked to gum disease may also play a role in the development of RA.

Some in the health community believe that these bacteria may cause an RA linked immune response by stimulating the production of proteins that trigger the formation of anti-citrullinated protein antibodies (ACPAs).

In the body, these compounds seem to stimulate an inflammatory response in various types of cell, including bone cells. Some studies have found that the response ACPAs cause in the body may have a role in the mediation of bone damage in the joints of patients with RA.

Researchers believe that the detection of ACPAs should now be considered the most specific biomarker for RA in the blood.

The early detection of ACPAs in a patient’s blood seems to help doctors better predict RA development several years prior to a patient developing a clinical case of RA or develops symptoms related to the disease.

This has led researchers to carefully study how changes to an individual’s oral microbiome may relate to the development of RA.

Changes to the Oral Microbiome Increase RA Risk

As part of their study, researchers from the Academic Centre for Dentistry of Amsterdam examined the oral microbiome and gum health of three groups, each containing 50 participants.

Participants in group A had ERA, and participants in group B include those with a risk of RA (people with ACPAs found in the blood samples). Participants in group C had neither ERA or RA, and did not have any autoimmune conditions.

Each participant underwent an oral examination by a dentist to determine the current state of their gum health. Dentists examined whether a participant’s gums bled when probed, how inflamed their gum tissue, and how deep under the gum line dental tools could probe.

Participants also had their teeth assessed, including how many were missing, filled, decayed, and whether they wore dentures. Participants were also asked to describe their daily oral hygiene routine and when they had last received professional dental care.

Researchers then collected and analyzed samples taken from the mouths of the participants to quantify the microbial populations within the samples. They then compared any microbial differences between the three groups.

Researchers identified no difference in gum health between the three groups, nor did they find any differences in the plaque samples collected from the participants.

However, differences were noted in the saliva samples taken from participants in the ERA and at risk of RA groups when they were compared to the control group.

Bacteria levels belonging to the genera Veillonella and Prevotella were elevated in the samples belonging to participants in groups A and B when compared to group C. Veillonella bacteria levels were also elevated in the RA group when compared to the control group.

To researchers, this suggests that bacteria from these two genera could help to trigger an immune response in the body that causes RA to develop. This indicates that a potential link exists between the oral microbiome and RA.

The findings from this latest study correspond to early research that found patients with newly onset RA and established RA had increased levels of Prevotella in the mouth. The results also support research that showed increased levels of Prevotella bacteria in the stomach of patients who were at risk of RA or who had ERA.

Some strain of Prevotella can cause chronic inflammation, which in turn triggers immune cells to be released throughout the body.

Effective Periodontal Treatment in Portland Does More Than Repair Your Smile

As we said at the beginning of this blog post, effective periodontal treatment in Portland works to do more for the body than simply repair the damage done by gum disease. A mouth/body connection exists, and the healthier your smile the healthier your body becomes.

Patients who visit Dr. Goldwyn at Portland Periodontics can take comfort in knowing that we understand this connection and work towards providing you with a great-looking smile that helps keep you healthy for a lifetime.