People, who suffer from gum disease and also have a severe form of rheumatoid arthritis, reduced their arthritic pain, number of swollen joints, and the degree of morning stiffness when they cured their dental problems, according to researchers from the Case Western Reserve University School of Dental Medicine, Cleveland, and University Hospitals of Cleveland.

The report on this new intervention for arthritis in published in the Journal of Periodontology, says Case Western.

This is not the first time that gum disease and rheumatoid arthritis have been linked, says Case Western: According to Ali Askari, MD, another researcher in the study and chair of the department of rheumatology at University Hospitals, “From way back, rheumatologists and other clinicians have been perplexed by the myth that gum disease may have a big role in causing systematic disease.”

He added that historically teeth were pulled or antibiotics given for treatment of rheumatoid arthritis, which actually treated the periodontitis.

Askari and [removed]Nabil Bissada, DDS[/removed], chair of the department of periodontics at the dental school. are part of a team of researchers that studied 40 patients with moderate to severe periodontal disease and a severe form of rheumatoid arthritis.

The study results should prompt rheumatologists to encourage their patients to be aware of the link between periodontal disease and rheumatoid arthritis, says Askari, in a posting on the Case Western Web site.

Bissada notes that gum disease tends to be prevalent in rheumatoid arthritis patients, says Case Western.

Both inflammatory diseases share similarities in the progression of the disease over time. In both diseases, the soft and hard tissues are destroyed from inflammation caused by toxins from bacterial infection, according to Case Western.

One toxin from the inflamed areas called tumor necrosis factor-alpha (TNF-α) is a marker present in the blood when inflammation is present in the body, says Case Western, adding that TNF-α can initiate new infections or aggravate sites where inflammation already exists.

The study’s participants were divided into four groups, says Case Western. Two groups of patients were receiving a new group of anti-TNF-α drugs that block the production of TNF-α at inflamed rheumatoid arthritis sites. Two groups were not on this new medication. Half of group of the participant on the medication and half not receiving the new drug received a standard nonsurgical form of periodontal treatment to clean and remove the infection from the bones and tissues in the gum areas. The other half of those studied did not receive the treatment until after completion of the study.

After receiving treatment for the gum disease, improvement in rheumatoid arthritis symptoms was seen in patients who did and did not receive the anti-TNF-α medications, which block the production of TNF-α that aggravate or can cause inflammation, notes Case Western. Patients on the TNF- α inhibitors showed even greater improvements over those not receiving the drugs.

Askari says he is optimistic that someday the biologic agents that are used successfully in treatment of rheumatoid arthritis will lead to improvement of periodontitis and would be available for use and treatment of this perplexing problem, accord

Other researchers contributing to findings in the article, Periodontal Therapy Reduces the Severity of Active Rheumatoid Arthritis in Patients Treated with or Without Tumor Necrosis Factor Inhibitors, were P. Ortiz, Yiping Han, Leena Palomo, and Ashok Panneerselvam from Case Western Reserve University; and MS Al-Zahrani from King Abdulaziz University, Jeddah, Saudi Arabia.

[Source: Case Western]