Rheumatoid Arthritis May Be Triggered by Mouth Bacteria

Inflammation in the gums and mouth bacteria may be a trigger behind the onset of rheumatoid arthritis, according to findings presented at the 93rd General Session and Exhibition of the International Association for Dental Research.

Rheumatoid arthritis (RA) onset is linked to periodontitis, according to findings presented at the 93rd General Session and Exhibition of the International Association for Dental Research.

Researchers from Massachusetts General Hospital in Boston performed joint and dental examinations on patients, determined Porphyromonas gingivalis (P. gingivalis) antibodies, and examined inflammatory microenvironments in early and chronic RA patients in order to determine if there is an association between periodontitis and RA.

The study included 23 RA patients (15 of whom had new onset RA and 8 had chronic RA) and 20 age- and gender matched health subjects (87 percent female) without periodontitis or RA. The researchers used 20 inflammatory mediators to measure in serum, saliva, gingival crevicular gluid (GCF), and joint fluid.

After receiving routine dental care, 10 of the 23 RA patients were discovered to have gingivitis and 9 had periodontitis. The RA patients experienced increased pocket depth, clinical attachment loss, bleeding on probing, and GCF volume compared with the healthy patients. There were 6 RA patients with P. gingivalis antibodies, and all 6 of those patients had periodontitis.

The researchers also demonstrated that the patients showed a marked inflammatory profile in all of the measured microenvironments, including oral, despite the routine dental care the participants underwent. Rheumatologists can consider P. gingivalis antibodies as identifying markers for those who may benefit from periodontal treatment, the researchers added.

The research was presented by researcher Sheila Arvikar, MD from Mass Gen, and the research presented is aligned with a long tradition of mouth bacteria being linked to RA. One article went so far as to say that researchers have linked mouth bacteria, and more specifically, gum infections, have been linked to the development of RA and appendicitis for nearly a century.