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Periodontal disease, comes in two forms gingivitis (reversible) and periodontitis (treatable but non reversible), is an infection of the gums caused by bacteria found in plaque. Recent studies have shown between 50-75% of people have some form of periodontal disease. More statistics show that approximately 30% of Americans are at an increased risk of developing periodontal disease due to genetic factors. These statistics show how much a health concern periodontal disease can be especially when you add in even more research showing periodontal disease links with systemic diseases.

Factors in Development of Periodontal Disease

-Poor Oral Hygiene.

-Tobacco Use.

-Medications.

-Teeth Grinding or Bruxism.

-Genetics.

-Poor Immune System

-Systemic disease.

The earliest and mildest stage of gum disease is gingivitis, where the gums redden and bleed easily. If not treated, inflammation of the tissue occurs, resulting in progression of  the disease to periodontitis. Gingivitis is characterized by receding gums, loose teeth, sores, sensitive gums, swollen gums, red or discolored gums, chronic bad breath, change in teeth alignment and teeth movement. The ultimate consequence of advanced periodontal disease is loss of teeth, which occurs when the tissue and bone supporting the tooth breaks down.

Periodontal disease was previously thought to affect only the teeth and gums, but researchers have discovered that periodontal disease influences the overall health and well-being of an individual. Research has shown that gum disease is a risk factor for many health conditions throughout the body. The gum disease causing bacteria that normally resides around the teeth can enter the blood stream and reach other organs and tissues in the body. Once there, the bacteria  release disease-causing agents that can lead to chronic inflammatory conditions that can include:

Diabetes Mellitus (or simply Diabetes)

Periodontal disease impairs the body’s ability to maintain blood sugar levels making you more prone to diabetes or making diabetic symptoms worse. On the other hand, diabetic patients are more likely to suffer from periodontal disease due to a weakened immune system, making it easier for them to catch infections, viruses, and exhibit delayed wound healing.

Stroke

According to scientific studies, gum disease increases the risk of stroke and coronary artery disease. A chronic infection of the gums can be directly related to an increased risk of reduced blood flow to the brain. Stroke and gum disease have similar risk factors and severe inflammation from periodontal disease increases the risks of having a stroke.

Heart Disease

Having periodontal disease puts you at higher risks of heart disease. Just like periodontal disease, heart disease is a chronic inflammatory disease which can be greatly impacted by periodontal disease. The more severe the periodontal infection, the higher the risk of developing heart conditions such as high blood pressure, high cholesterol and acute coronary syndrome.

Respiratory Infections

When the bacteria in the plaque that causes gum disease goes to the lungs, it can cause respiratory diseases such as pneumonia. This explains the increased cases of pneumonia and other respiratory conditions in people with periodontal disease. This also is in conjunction with patients with lowered immune systems which makes it easier for them to be susceptible to these bacterial attacks.

Cancer

After considering risk factors for cancer including age, diabetes, smoking, BMI and more, experts found periodontal disease as a risk factor for lung, kidney, pancreatic, head, neck and hematologic cancers. Inflammation caused by periodontal disease is a major contributing factor to these cancers.

Bad Breath (Halitosis)

Periodontal disease can result in chronic bad breath which is more of a social issue than a medical one. Bacteria deposits on the tongue can also cause bad breath. This is one of the few conditions caused by periodontal disease that can be treated at home by practicing proper dental care to control halitosis (brushing, flossing, mouthrinses, tongue scraping).

Complications with Birth and Pregnancy

Periodontal disease in pregnant mothers has been shown to increase the risk of premature delivery and low birth weight. The  periodontal bacteria involved cause inflammation of the uterus and cervix. Periodontal disease also increases the risk of developing preeclampsia, a condition characterized by high blood pressure and excess protein.

Rheumatoid Arthritis

Rheumatoid arthritis is a painful chronic inflammatory disease that affects the joints. The relationship between rheumatoid arthritis and periodontal disease goes both ways as each increases inflammation in the other. Patients with rheumatoid arthritis are faced with increased risks and severity of periodontal disease and treating periodontal disease can relieve some of the symptoms of rheumatoid arthritis.

Conclusion

The best and easiest way to prevent and control periodontal disease is by maintaining a good oral hygiene program which includes regular dental visits as well as diligent at home care. This includes brushing, flossing, use of mouth rinse, and tongue scraping. Your health is important, taking care of your dental health is a great way to start taking care of your overall health.

 

Arthritis and periodontal disease are generally not thought of as occurring together. We generally think of these inflammatory diseases individually, without much thought as to how they are affected by other diseases or how they may exacerbate disease in the body.

Rheumatoid arthritis is an autoimmune inflammatory disease in which our own cells attack the joints. The disease causes inflammation, pain and stiffness. This can progress to severe bone damage, causing  a disability of the affected joints.

Periodontal disease is a chronic inflammatory disease caused by bacteria that trigger an inflammation of the gums. Further breakdown is caused by our own cells in defense against the periodontal bacteria..

In separate studies, researchers have found a two-way relationship between these two conditions where rheumatoid arthritis patients face higher risks of developing gum disease and periodontal disease patients have increased risk of rheumatoid arthritis.

What Is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a disease that leads to inflammation of the joints and surrounding tissues. It can also affect other organs.  The cause of Rheumatoid Arthritis is not known. It is classified as an autoimmune disease, which means the body’s immune system mistakenly attacks healthy tissue. It can occur at any age, but is more common in middle age. Women get rheumatoid arthritis more often than men.

The symptoms can include:

-Morning stiffness, lasting longer than 1 hour, is common. Joints may feel warm, tender, and stiff when not used for an hour or so.

-Joint pain is usually felt on the same joint on both sides of the body.

-Over time, joints may lose their range of motion and may become deformed.

Other symptoms include:

-Chest pain when taking a breath (pleurisy).

-Dry eyes and mouth (Sjogren syndrome).

-Eye burning, itchy eyes, and discharge from eyes.

-Nodules under the skin (usually a sign of more severe disease process).

-Numbness, tingling, or burning in the hands and feet.

-Difficulty sleeping.

Periodontal Disease and Arthritis Link

There is a high incidence of periodontal disease in patients with rheumatoid arthritis. The link between the two can include:

-Periodontal disease and rheumatoid arthritis both occur as a result of  chronic inflammatory responses by the body. This leads to destruction of supporting tissues and bone.

-They have similar characteristics, risk factors, and pathological processes. Smoking is a common risk factor between rheumatoid arthritis and periodontal disease. Smoking causes both conditions to worsen.

-When a patient has both rheumatoid arthritis and periodontal disease, they have more anti-citrullinated protein antibodies (ACPA), which cause even more inflammation in the gums and other parts of the body, making all inflammatory conditions worsen . ACPA increases rheumatoid arthritis disease activity and the level of inflammatory markers.

-research studies have found that patients with both periodontal disease and rheumatoid arhtritis  have  experienced decreased pain, swelling and stiffness after periodontal gum treatments.

-Periodontal disease is responsible for chronic inflammation in the mouth, which can trigger chronic inflammation in other parts of the body, including the joints.

How Does Periodontal Disease Trigger Rheumatoid Arthritis?

Periodontal disease can set off  rheumatoid arthritis in many ways:

-The bacteria causing periodontal disease enters the blood stream and settles in the synovial fluid that lubricates the joints triggering inflammation in the joints.

-research studies have established that periodontal disease may decrease the effectiveness of tumor necrosis factor inhibitor treatment for rheumatoid arthritis. This makes it harder to treat rheumatoid arthritis using this treatment in patients with periodontal disease.

-The inflammation caused by the periodontal disease causing bacteria can raise the level of cytokines, which promote the release of CRP from the liver and result in systematic inflammation in the whole body, causing inflammatory conditions such as rheumatoid arthritis.

-Treatment of periodontal disease decreases rheumatoid arthritis symptoms such as joint pain and inflammation.

Can Rheumatoid Arthritis Contribute to Periodontal Disease?

The following are a few ways that rheumatoid arthritis can add to periodontal disease:

-Generally, symptoms from periodontal disease are more severe in patients with rheumatoid arthritis. For example, they have deeper periodontal pockets between the teeth and gums, making it easier to develop infections.Rheumatoid arthritis sufferers are faced with an increased risk of developing periodontal disease and severe jawbone loss.

-While both conditions stem from a chronic inflammatory response and weakened immune system, rheumatoid arthritis damages hand dexterity function, making it hard for patients to take proper care of their teeth using regular dental hygiene techniques. This not only increases the chance of developing new gum problems, but also makes existing gum problems much worse.

-Rheumatoid arthritis increases the risk of developing periodontal problems since alveolar bone loss in arthritic patients is linked to decreasing periodontal health, which has a greater chance of progressing into periodontal disease.

-The bacteria that cause gum disease access the blood circulation. This makes it possible for antibiotics administered to treat arthritis to also kill gum disease bacteria. This way, treating arthritis leads to an improvement in periodontal disease and treating gum disease improves the symptoms of arthritis.

Conclusion

It is important to remember these two conditions do not always occur together. There are plenty of periodontal disease patients who don’t have arthritis and many patients with rheumatoid disease who have healthy gums. While it is not clear which conditions occur first, and there is no conclusive evidence that these two conditions have a connection, the awareness of the association between rheumatoid arthritis and periodontal disease makes it necessary for patients of rheumatoid arthritis to visit a dentist or periodontist for evaluations and treatment regularly. Patients of rheumatoid arthritis should also make a point of regularly practicing proper dental hygiene maintenance, including brushing and flossing.