Help Stop Tooth Decay...and Prevent RA?

Among his many astute medical observations, Sir William Osler is credited with noting that “The health of the mouth is the window to the health of the body.” With more than a century elapsed, this statement now appears prophetic with a rapidly expanding body of contemporary literature linking oral health with both the risk and progression of systemic disease. Several studies have now shown associations of cardiovascular disease, obstructive lung disease, and diabetes, among others, with periodontitis (PD), a bacterially mediated chronic inflammatory disease involving the gums and surrounding connective tissues. More recently, PD has been implicated as a risk factor in systemic rheumatic illness, most notably in the development and progression of rheumatoid arthritis (RA). Snyderman and McCarty were among the first to comment on the shared attributes of PD and RA, similarities that include “self-sustaining inflammation in a fluid-filled compartment adjacent to bone” — noting that inflammatory pathways in both diseases lead to pain, swelling, and tenderness in addition to erosive destruction of adjacent bone1. PD and RA also share similar cellular, enzymatic, and cytokine profiles including the “overexpression” of matrix metalloproteinases and tumor necrosis factor (TNF), and share common disease risk factors that include both HLA-DRB1 alleles and cigarette smoking. In addition, therapies used in RA treatment, both tetracyclines (metalloproteinase inhibitors) and biologic response modifiers, appear to be effective in the treatment of PD2–4. Kasser, et al found that patients with RA compared to healthy controls …