Arthritis Foundation of South Africa
1,027 members59 posts

See your dentist regularly – you can’t lose!

Ever wondered about your toothbrush? Its European history? Who invented it? The role it plays in your health? I decided to do some research. In the year 1770, Incarcerated in a cell of England's Newgate Prison for provoking a riot, William Addis had little to do but eat, sleep and think. He thought a good deal about some new means of making a living once his sentence was served.

One morning, he began to clean his teeth - rubbing a rag against them. From ancient times, this had been the accepted practice. Aristotle had advised Alexander the Great to use a rag on his teeth. George Washington's dentist had suggested a rag with some chalk on it. Now, using the same method, the imprisoned Addis considered it ineffective.

The following day, he saved a small bone from the meat he'd been served. He bored tiny holes in the bone, then acquired some hard bristles through his prison guard, cut them down, tied them into tufts, put glue on the ends, and wedged them into the holes in the bone.

After his release, he started manufacturing the toothbrushes he had built. By 1840 toothbrushes were being mass-produced. Today, the company continues to do business under the name of Wisdom Toothbrushes.

Why the history lesson? And, what relationship, if any, is there between the humble toothbrush and arthritis? A conversation with my dentist soon provided the answers. Losing teeth can do more than affect the ability to enjoy a fresh, crunchy apple or flash a healthy smile. Research suggests that tooth loss – a marker for periodontal (gum) disease – may predict rheumatoid arthritis and its severity. The more teeth lost, the greater the risk of RA, one study found.

In the study of 540 patients with early arthritis, presented at the 2012 European Congress of Rheumatology in Berlin, 24 percent had 10 or fewer teeth, 15 percent had 11 to 20 and 22 percent had 28 or more teeth. (A full set of adult teeth, including wisdom teeth, numbers 32.)

At six months’ follow-up, 52 percent had a good response to treatment, 32 percent had a moderate response and 16 had no response. The worst prognosis was for those with the fewest teeth. People with 10 or fewer teeth had more severe arthritis – evidenced by a significantly greater erythrocyte sedimentation rate, higher tender and swollen joint counts, and a higher Disease Activity Score – than those with more than 10 teeth.

How are these two disorders related? Rheumatoid arthritis and periodontitis (gum disease) share some common characteristics. Rheumatoid arthritis is an inflammatory disease wherein the autoimmune system attacks the hard and soft tissue of the joints. Periodontitis is a bacterially incited inflammatory disease wherein the autoimmune system attacks hard (bony) and soft (gum) tissue around the teeth. Bacteria that cause gum disease have been found in the joints of patients with rheumatoid arthritis. Patients with rheumatoid arthritis have been shown to have more antibodies against bacteria that cause gum disease than those patients without rheumatoid arthritis.

An article published in January, 2008, in the Journal of Rheumatoid Arthritis, called ”Association of periodontal disease and tooth loss with rheumatoid arthritis in the US population,” concluded that rheumatoid arthritis may be associated with tooth loss and periodontitis.”

It appears that studies reported in both medical and dental journals acknowledge the association between rheumatoid arthritis and periodontitis. Although there is no scientific basis to definitively conclude that there is a “causal” relationship as yet, there is no downside risk in having one’s gum disease treated, rheumatoid arthritis or not. Furthermore there is no dispute that removing infection from the gums and the mouth will not only save teeth, but also certainly improve one’s general health. In conclusion, for the rheumatoid arthritis patient who has gum disease and everybody else, only good can come out of seeing the dentist. So see your dentist regularly. You can’t lose!