Dental diseases

The relationship between rheumatoid arthritis and pyorrhea of ​​the teeth.

Before and after periodontitis.

Pyorrhea or periodontitis is a pathology that causes multiple tooth loss. The ligament that holds the tooth in place in the bone becomes inflamed and damaged. The teeth appear healthy, i.e. without cavities or visible changes.

In addition to 70% of our patients who suffer from pyorrhea and who want to have dental implants in Albania at the same time have joint problems and difficulties in various movements.

They might seem like two unrelated things but the truth is that they are related in the scientific way.

How is periodontitis, i.e. pyorrhea, caused?

  •  bacteria
  •  hygiene
  •  genetics
  •  autoimmune diseases
  •  trauma
  •  systemic diseases such as diabetes
  •  hormonal disorders etc.

Patient with pyorrhea/periodontitis. The teeth appear healthy but move.

What causes rheumatoid arthritis?

  • genetic predisposition
  •  joint trauma
  •  teeth diseases
  •  idiopathic etc.

Rheumatoid arthritis is a systemic pathology while periodontitis is a local pathology that affects only the teeth, but causes other problems.

Regardless of the cause of periodontitis , bacteria are always present. The two main microorganisms are T. denticola and P. Gingivalis, against which our body produces antibodies. However, these antibodies do not only attack these two bacteria but at the same time also other human organs and tissues such as:

  •  the joints, thus causing rheumatoid arthritis
  •  the heart, damaging the valves and causing heart failure
  •  the kidneys, causing renal failure

The accumulation of antibodies in the joints is the most frequent thing and happens in more than 60% of cases. This phenomenon is gradual and takes 15-20 years to cause perceived damage, i.e. clinical symptoms.

Initially, patients feel heavy in their joints, a sensation that over time turns into pain and difficulty in movement. The joints change shape and become irregular.

Since the teeth are always neglected, these patients do not consider treating them but concentrate on the biggest problem which is rheumatoid arthritis. They take treatments for years and years but without solving the problem.

Rheumatoid arthritis caused by antibodies against pyorrhea bacteria accounts for around 60%. The cure for these patients is not expensive arthritis medicines but something much simpler, the extraction of the infected teeth.

When the tooth is extracted, the periodontal ligament is also removed and consequently also the chronic inflammation. The bacteria that caused pyorrhea are no longer present, so our body no longer produces antibodies. The joints are no longer “attacked” by the antibodies and the patient begins to see improvements within a few weeks.

This treatment is not effective for other forms of arthritis that are not caused by periodontitis. For those forms, treatment according to the protocol with medicines is necessary.

In our dental clinic in Albania, Oxa Clinic, we have had several patients who have been suffering from pyorrhea and rheumatoid arthritis for years. When we explain to our patients that there is a high probability that periodontitis can also go away with tooth extraction, it seems impossible, but in a few weeks the patients feel improvements.

In these cases, patients must still consult with the rheumatologist to also carry out biochemical analyzes to understand if the antibody levels have dropped.

Most of these patients need a total tooth extraction.

We are thus faced with a situation in which a total rehabilitation of the two arches with dental implants is needed.

Before and after periodontitis.

Clinical case of Cristina Giorgi, 55 years old. She had been suffering from periodontitis for more than 10 years and had been diagnosed with rheumatoid arthritis for 3 years. The teeth were moving and he wanted to do a total rehabilitation of the two arches. We did the first phase in which we extracted the teeth and inserted the implants. Two months later during routine rheumatoid arthritis checks they discovered that he was making improvements. When she returned for the second phase, to get her permanent teeth, her doctor had stopped her arthritis medications. In the space of just 4 months he was able to regain both chewing and joint flexibility.

We must point out that tooth extraction can improve rheumatoid arthritis only in those cases where the arthritis was caused by antibodies against periodontitis bacteria. For other forms, treatment prescribed by a rheumatologist is required.