Did you know there is a mouth-body connection? Research has demonstrated a link between periodontal (gum) disease and rheumatoid arthritis, an autoimmune disease. Although oral health and joint pain may seem unrelated, as we learn more about the oral microbiome, they may be closer than we imagined.

Mysteries of the Mouth

The oral microbiome is a community of microbes that reside in the human mouth. These microbes have a symbiotic relationship with us, and create their own carefully balanced ecosystem. When in balance, that ecosystem promotes our health. However, when it is unbalanced, it can lead to oral and even systemic disease.

New research has found that periodontal disease may be caused by the disruption of the oral microbiome. Periodontal disease, also known as gum disease, is a common condition that usually develops in a patient’s 30s or 40s. It is characterized by bad breath, swollen gums, and loose teeth, among other symptoms. Originally, it was thought that bad bacteria in the mouth, found in the form of plaque, caused periodontal disease. As we learn more about the oral microbiome, our understanding of periodontal disease becomes less clear.

We are just beginning to learn about the composition of this complex community, and how it might relate to autoimmunity. What we do know is that the oral microbiome is connected to microbes all over our body, which create their own communities in areas such as the gut and lungs. These microbiomes have different microbe compositions, but are all distinctly related to each other. Immune responses to these microbiomes may be related to autoimmune disease.

Rheumatoid Arthritis: A Response to the Oral Microbiome?

Rheumatoid arthritis is an autoimmune disease that affects about 1.5 million people in the United States. It affects the joints, particularly the wrists and fingers, resulting in swelling and pain. Rheumatoid arthritis is different than normal arthritis in that it is symmetrical (if you have it in one hand, you are likely to have it in the other) and may include other symptoms, such as fevers and fatigue.

The microbiome may prove to be one factor in the multiple causes of rheumatoid arthritis. Research has found that rheumatoid arthritis is likely caused by high exposure to bacterial antigens, which enter the body through the mouth, gut and lungs.

What’s the connection?

So what do periodontal disease and rheumatoid arthritis have in common? And how is it related to the oral microbiome?

Recent studies have discovered that the microbiome may be a “trigger,” an “environmental factor that can influence autoimmune disease manifestation.” An examination of patients with new-onset rheumatoid arthritis found they had a much higher prevalence of periodontal disease than the general population. This was the case despite the fact that they were young non-smokers. This could be a side effect of rheumatoid arthritis, or it may be a precursor to it. If it is a precursor, the health of the microbiome and the development of periodontal disease could tell us in advance that an individual may develop rheumatoid arthritis.

Research to determine the exact relationship between the oral microbiome, periodontal disease, and rheumatoid arthritis is ongoing. If periodontal disease is a precursor to rheumatoid arthritis, we may be able to prevent the autoimmune response entirely.

Does this mean we will be able to treat and even prevent rheumatoid arthritis? Is the oral microbiome a new vital resource for determining and promoting total body health? Only time will tell.

Have you, or someone you know, been diagnosed with both advanced periodontal disease and rheumatoid arthritis? Tell us your story!

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