June 9, 2023

Periodontitis is associated with a number of systemic diseases, either due to the passage of pathogenic periodontal bacteria into the blood (such as Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans) or due to the production of systemic inflammation, which will have different effects throughout the body. For its part, rheumatoid arthritis is a systemic autoimmune chronic inflammatory disease, that affects the joints, causing cartilage and bone destruction, It is estimated that it affects about 1% of the world’s population.
Rheumatoid arthritis and periodontitis are chronic inflammatory diseases that share similar pathways. and inflammatory and immune regulatory mechanisms, as well as genetic factors and other risk factors, such as smoking and poor oral hygiene. It is believed that inflammation on the surface of the oral mucosa (gums) triggers the systemic autoimmune disease that occurs in rheumatoid arthritis.
Although the cause of rheumatoid arthritis remains unknown, several epidemiological studies have suggested an association between rheumatoid arthritis and periodontitis. The most widely accepted hypothesis linking these two diseases Periodontal microorganism is based on porphyromonas gingivalis (main bacteria causing periodontitis), Its presence has been detected in the joints of patients with rheumatoid arthritis and its ability to induce an autoimmune response that may be exacerbated by the development of arthritis has been described.
In this sense, a research group from the Complutense University (UCM) of Madrid and the University Hospital of the Canary Islands (HUC in Santa Cruz de Tenerife) has shown a very strong link between periodontitis and rheumatoid arthritis. Too, The more severe the periodontitis, the more active and aggressive the rheumatoid arthritis seems to be., But, similarly, clinical parameters of the severity of periodontitis have been correlated with the presence of antibodies (called citrullinated antibodies), which are a typical marker of more progressive and aggressive rheumatoid arthritis.
A few experimental studies and clinical trials with a small sample of patients that have evaluated the effect of non-surgical periodontal treatment on the activity of rheumatoid arthritis and suggest that the treatment of periodontitis may have a significant favorable effect on the disease may, although more rigorous controlled clinical studies are needed to confirm this.
Currently, this research group is Evaluating the efficacy of periodontal treatment in patients with advanced periodontitis and high activity rheumatoid arthritis, If the initial hypothesis is confirmed, it would be shown that treatment of gingivitis in this type of patient can have a direct positive effect on the control of rheumatoid arthritis, given the health costs of the drugs used in the management. able to reduce. Rheumatoid arthritis is a high economic burden for the health system.
In any case, taking into account the evidence from epidemiological data, Patients with rheumatoid arthritis should be advised to see their dentist and pay special attention to their periodontal health, In addition, it should be kept in mind that many people with this chronic autoimmune disease have more difficulties in performing proper oral hygiene as they suffer from joint disease and, therefore, require the necessary advice and support from their dentist. .
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