| People who simultaneously suffer with periodontal disease along with a severe form of rheumatoid arthritis, reduced their arthritic pain, number of swollen joints and the degree of morning stiffness when the periodontal problems were treated. Researchers from the Case Western Reserve University School of Dental Medicine and University Hospitals of Cleveland reported on this new intervention for arthritis in the latest issue of Journal of Periodontology.
"It was exciting to find that if we eliminated the periodontal infection and inflammation, 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. 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--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.
"Again we are seeing another link where good oral health improves the overall health of an individual," says Bissada.
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