Association Among Rheumatoid Arthritis, Oral Hygiene, and Periodontitis

Abstract

Subjects with RA have significantly increased periodontal attachment loss compared to controls. Oral hygiene may only partially account for this association.

Periodontitis and arthritis interaction in mice involves a shared hyper-inflammatory genotype and functional immunological interferences

“…Indeed, RA can increase the incidence and severity of PD (independently or only partially dependent) of oral hygiene status or modifying factors. [4][5][6][7]15,16,35 Accordingly, our results show that PIA increase the severity of ePD in AIRmax mice strain, whereas in AIRmin strain (resistant to PIA development), [25][26][27][28] the severity of ePD was not altered by pristane injection, showing that the development of PIA, and not the pristane injection, is involved in the modulation of ePD severity. Similarly, adjuvant-induced arthritis in rats also results in signs of periodontal destruction.…”

“…[14][15][16]23 Noncausal hypothesis state that environmental or host factors could concomitantly increase susceptibility to both RA and PD. [4][5][6][7] Accordingly, our data show that AIRmin and AIRmax mice strains share the susceptibility/resistance phenotype to both PIA and ePD. [24][25][26][27][28] This finding is reinforced in the view of the absence of environmental factors potentially involved in such interaction (namely socio-economic status and tobacco smoking) 16 in the experimental models used in this study.…”

“…Indeed, as earlier discussed, clinical studies show that RA/PD interaction is only partially dependent on oral hygiene status and the control of oral flora. 4,5,15,16,35 Another well-defined situation of co-induction, described as a two-hit model, is acute respiratory distress syndrome. In acute respiratory distress syndrome, ventilator-induced lung injury does not predictably result in lung tissue destruction, but does promote the accumulation of PMN leukocytes in the lung alveoli (the first hit), which followed by the injection of a relatively low dose of endotoxin (the second hit) induces PMNL degranulation, irreversible lung destruction and death.…”

“…[1][2][3] Results from clinical studies point toward a co-morbidity association between chronic periodontitis (PD) and systemic rheumatic diseases, in particular rheumatoid arthritis (RA), described to increase the incidence and/or severity of PD, a chronic infectious inflammatory disease that leads to the destruction of the teeth attachment structures. [4][5][6][7] Chronic PD is the most prevalent chronic inflammatory disease in human beings, in which bacterial species that hosts periodontal biofilm trigger inflammatory and immune responses involved in tissue damage. 8,9 RA is a chronic autoimmune inflammatory disease that possibly arise because of a failure in thymic selection or a peripheral tolerance (the early mechanisms by which immune tolerance is breached and the subsequent event that triggers articular localization is poorly defined), characterized by persistent synovial inflammation and progressive destruction of cartilage and bone in the joints.…”

Experimental Arthritis Triggers Periodontal Disease in Mice: Involvement of TNF-α and the Oral Microbiota

“…T he association between autoimmune rheumatic diseases and chronic infectious periodontal disease (PD), the leading cause of tooth loss in humans, has been studied since the 1960s (1); however, it has received increasing attention lately (2)(3)(4)(5). Data from several clinical studies suggested a potential relationship between these disorders and indicated that individuals with rheumatoid arthritis (RA) are more likely to experience periodontal problems compared with healthy counterparts (2,3,(6)(7)(8)(9)(10)(11)(12)(13).…”