I've been diagnosed with rheumatoid arthritis since the beginning of 2023, but I've had symptoms for probably a year or more before that. Only been taking methotrexate for 5 months. The last couple of visits to my dental hygienist have not been good at all. I'm being told I have gum disease with periodontal pockets that need cleaning out. But all of this is a huge shock to me because I've never had any problems with my oral health before and I brush and floss twice daily and do everything right!!
Is the rheumatoid arthritis causing the gum disease or could it be the methotrexate?! Has anyone else experienced this? If yes what did you do? Did it get better? I'm so worried I'm going to loose my teeth.
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Purplemusic
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Thanks for the reply. Are you finding the gum disease is because of the RA? Is your gym disease getting worse or are you and your hygienist keeping it under control?
It’s hard to know for sure. I’ve had RA diagnosis for 16 years, and symptoms for a while before that. It all kicked off around the birth of my eldest child and pregnancy can cause teeth issues too. All I know is I never had problems before but since I’ve had to have regular hygienist appointments and be meticulous in cleaning. Think we’re more or less keeping on top of it.
Thank you for your reply. Yes I have been researching and have come across links between the two conditions. I just hope I can manage not to loose teeth because of this. Its one of my nightmares loosing teeth 😬
Defo a connection. I thought I was going to loose my teeth. Had terrible inflammation in my gums at first. Teeth still sensitive and I have lots of pockets so I see my hygienist every 3 months and so far it's all under control. I started with RA 7 years ago and take a biologic.
I am experiencing severely sensitive teeth which started about 5 months from starting MTX. I really need to get a dental appointment to have it checked out (our dentist currently does only annual checks for people with good gum health). Like you I've always had good dental visits with excellent gum health and clean my teeth well.
I started having sore mouth and bleeding about five months after starting methotrexate. I was also having bad stomach pains 4 days after each injection. I stopped the MTX for my covid jab, and immediately my stomach pains stopped. The bleeding also stopped. Three weeks later I saw my dentist who said I didn't have gum disease, everything was fine.
I haven't restarted the MTX and haven't had bleeding or stomach pain, nor headaches since.
My hygienist said there is a link between gum disease and RA. Like you I had pockets, which needed cleaning out. I was horrified a d very worried about losing teeth. Regular visits to the hygienist( every 2-3 months initially) plus a very, very thorough cleaning programme seems to have sorted it and its now under control. I can't remember how long it took to settle the pockets. Thankfully, I never lost any teeth. My hygienist is very good, and took time to go through a cleaning routine with me. She showed me how to brush properly with an electric brush ( apparently I wasn't 🙂) She also recommended I use Te Pe interdental brushes and a brush called a sulcabrush which cleans the front and back margins between tooth and gum . Apologies if you know all this - just sharing things which work for me.
It seemed a lot of work at first but I've got into the routine now and am keeping on top of it.
I have been on methotrexate over four years. I have a pocket. My dentist has cleaned it and checks it and my teeth every six months. I use inter dental brushes around it to keep pocket clean. I don’t worry about my teeth but we need to look after them. I wouldn’t worry if I was you. It’s quite common.
me too! I had to go to the dental hospital where they cut my gums to clean . I have very good dental hygiene and never had a filling until I was diagnosed at 45 . Was told it’s RA related by dental hospital. I still have problems 56 now and have deep clean of my gums every 6 months. RA the gift that keeps on giving. Meds can effect gums too
I have severe RA - no gum issues- but annoying dry mouth from RA has created decay issues - very upsetting - since I have always taken good care of my teeth.
Had some bad/greedy dentists - & now go for a second opinion if they want to do extractions, implants & other expensive procedures.
It could be but then again I’m 70 with a full set of teeth about 12 fillings and 1 crown so don’t worry to much as all you can do is keep to good dental hygiene and all the rest of the usual advice. I’ve had RA over 25 years now so my view is who knows?.
No gum disease but I’ve had 3 fillings and a root canal in the last 2-3 years. Never any issues prior to RA have always visited dentist every 6 months.
I had bleeding gums & mouth ulcers for years prior to being diagnosed with RA. I was told it is possible that was the cause of my RA. There is definitely a link but I also seem to remember that Methotrexate can damage teeth. I was on it for 15 years & have been ok. I have lost 1 tooth but that was due to an abcess. I think if you have a good dentist & regular hygienist appointments in between you should stay on the right track. Try not to worry x
Note my diagnosis is Adult onset Stills Disease which for me manifests as rheumatoid disease. Diagnosed aged 17, steroids etc until mid 20s, chronic symptoms persist, now 61. Teeth ok but overgrowth of soft gum tissue to a sizeable lump visible with mouth closed. Had this removed in hospital 20 years ago but it is growing back in the same place. GP snd dentist clueless but research suggests RA connection. I also have other skin issues also RA or autoimmune connected . I don’t have a cure to share but haven’t lost any teeth yet.
My dentist prescribed special toothpaste when I thought I had toothache…she explained I had inflamed gums & said it is connected with RA. ..the toothpaste does help…..ask your dentist about it…….if it’s appropriate for you……you need a prescription.
It’s nothing to do with a person’s oral hygiene …..as your hygienist explained we can’t get into all the little crevices between our teeth & as we get older, our teeth drift apart a bit & there are more hidden pockets we can’t get at,
No matter how we buy expensive electric toothbrushes we need regular attention from the hygienist to thoroughly clean between the teeth.
But don’t worry..I’m 80+ & still have all my own teeth & they look fine. Your hygienist will get it under control.
Agree with the comments here. There is a link. The key is good dental care and regular hygiene visits, plus daily (preferably twice a day) flossing. The interdent brush suit me, but find whatever fits for you and on the advice of your hygienist. Good dental care is so important.
I think the interdental brushes without metal are preferable to use ..my dentist originally gave me a packet of them & advised against the metal..I did try them but they seemed very harsh so I went back to the gentler plastic.
It probably is as I was on methotrexate for about 3years until it scarred my liver,I’m on Toxilimunumb now but as I post am waiting in the Dentist for a hygienist as I’ve gum disease now
Oh wow, all these comments on how RA effects the mouth, teeth and gums. I never knew when I was diagnosed that there would be so much more to RA than inflammation of the joints (that's bad enough!) 👎 But I have hope now that with regular visits to the hygienist I will not loose all my teeth! Thank you for replying everyone.
I'm not diagnosed with anything yet, so unsure whether I'm relevant to this discussion, but I've had terrible problems with gum disease for years. I recently have been to the dental hospital to discuss an impacted wisdom tooth that needs taking out and the letter said I have 50-80% bone loss in my jaw. They've said 50% bone loss to me in person before, but seeing 80% written down brought me out in a cold sweat! They say they don't know why my gums are so bad, but some of it can be genetic. I think my Dad has had similar problems and we do have other health problems in common (psoriasis, Raynaud's - my psoriasis is milder, but Raynaud's worse). Unfortunately, I also seem to have a very small jaw, so this is the second wisdom tooth that's been an issue. I have some symptoms of Sjögren's syndrome, which could be a factor.
I'm also 43, but have had this problem for about 20 years, so if you're only just starting to have gum disease then you probably stand a better chance of getting it under control. I think in my 20s I just got shouted at my some dentists for not cleaning my teeth properly, when that actually wasn't the problem. I use interdental brushes and floss everyday, which you might find helpful, if you're not already doing that, and Corsodyl mouthwash is also good to get it under control. I also have geographic tongue, so can't tolerate mouthwash, but my husband finds it really helpful.
If you have more than one impacted Wisdom tooth…ask to get them all removed in one go…they will probably all need to come out & my dentist suggested all at once was the simplest way.
I had all 4 removed in my 20’s..& never had any more trouble with overcrowding in my mouth.
I should've been a bit clearer, but I had one impacted wisdom tooth a few years ago, which was removed at the hospital because it was at such an angle. This is the other upper one and only popped out a tiny bit a year or so ago, but didn't cause any issues until I had a possible sinus infection due to Covid last Christmas. Now I need to have the wisdom tooth and the one next to it removed, as it's damaged the root of that one too. No sign of either bottom ones (and hope it remains that way!) and these two didn't appear until my mid to late 30s for some reason. I feel wise enough now, so hopefully this will be an end to it 😂
What a coincidence…I too had a suspected sinus problem …that turned out to be an impacted upper Wisdom tooth.
My Wisdom teeth did not come through at all,& my dentist at the time said there was no room in my jaw for them to come through,& as you say….they would damage the teeth next to them if he left them in place.
So all 4 whipped out in hospital under a general anaesthetic…..no probs all…except the celery they gave me in the meal I was given to eat when I woke up ….Ouch!!
I got just one still coming through. My dentist said leave well alone. And cutting a new tooth at 60 must have been a record. It’s been 10 years, no pain but it’s still not completely through. I know there there as seen on X-rays but just not erupted yet.
That is great….if your dentist thinks you have room in your jaw for them to come through he has obviously advised you well.
But right now my back teeth are as far back in my jaw as there is bone.If four more teeth had tried to come through…all my teeth would have been squashed out of line…. luckily only my bottom teeth are a bit crooked..& I haven’t had to have any special treatment to my top teeth.
Sorry to hear you are having such a difficult time.I had great oral health no issues until I was diagnosed with R.A and started taking MXT. My gums have been inflamed a few times, teeth weak with hot & cold tooth sensitivity 😫; I was told by my dentist both condition and medication cause oral health problems.
Since then I see my dentist every 6mths. So far so good still have my teeth 🤞but honestly have answers other than keep up with your good oral hygiene and see the dentist at least two to three times a year.
I have discovered a sonic toothbrush which is such a relief after conventional brushing/flossing for sensitive teeth/gums.Gentle cleaning with no blood or soreness. I don't see the dentist until December so await their comment on sonic toothbrushes.
I had never heard of them until hearing a discussion on the radio. Thought they must be hugely expensive and then saw a travel version in Home Bargains at £ 2.99. 2 heads and battery included. Why not to try ?
I had a pocket around one tooth. It kept bleeding spontaneously and at night was the dread of waking up with a mouth full of blood. I saw my dentist and she said it was swollen papillae. She burnt the gum away twice. She retired and I saw another dentist and he gave that area of gum and tooth a good clean and xrayed. It has all cleared up. So teepee etc is all I use now. And visits to Hygienist. And having a good Dentist.
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