Periodontitis and rheumatoid arthritis

Abstract

Rheumatoid Arthritis (RA) is a chronic immune-mediated inflammatory disease that affects between 0.5 to 1% of the world population. RA is characterized by chronic and progressive inflammation of the synovium that leads to the destruction of the cartilage and bone. While the cause of RA remains unknown, several epidemiological studies have reported an association between RA and periodontitis. The most accepted hypothesis linking these two diseases is based on Porphyromonas gingivalis and its unique capability to citrullinate human and bacterial proteins, which could break the tolerance to citrullinated proteins and start an autoimmune reaction that leads to RA. A few pilot and small studies evaluating the effect of non-surgical periodontal therapy on RA disease RA but more rigorous clinical controlled trials are needed. If proven, periodontal therapy could be a non-expensive, non-pharmaceutical way of improving RA. In addition, based on the evidence from epidemiological data, patients diagnosed with RA should be advised to visit their dentist and maintain special care with their periodontal health.