Is there a connection between inflammatory arthritis and periodontal disease?

Question

I am currently having pain in several joints. My knees, fingers and toes are the most painful. I also have tingling in my ring and pinky fingers. Over the last week I have developed a very stiff neck, neck pain and I feel dizzy when I move my head to look upward. Along with my joint pain, I am having a terrible time with my teeth. Last July (2006) I had oral surgery (an Apicoectomy) due to an abscessed upper molar. My stitches opened up 3 days later, I got a post op infection, and now I am having trouble with several other upper teeth. I have uncomfortable pressure in my upper jaw, palate, nose and cheek bones. My throat is very red and sore, too. Even my tonsils have atrophied during the last year since my surgery (my rheumatologist even recently asked if I had my tonsils removed as a child). I have very little facial swelling, though, and just some gingavitis and mild redness the gums. My dentist says their “boggy”. Doctors are baffled as to what is causing all my dental problems and joint pain. 5 years ago I did have a bought of arthritis. Then, my rheumatoid factor was 38. However, all subsequent tests have been negative, including an ANA and one recent Elisa test for Lymes disease. So, my question is, could my arthritis be related to an ongoing infection (dental, or Lymes); or, would it be wise to keep persuing a autoimmune cause? With each round of clindamycin I do start to feel better…dentally and with my joint pain. After all these rounds of antibiotics, though, is it still possible to even have a lingering infection? If so, what would keep it from clearing all the way? Would it also be wise to be rechecked for Lymes disease? Thanks for taking the time to answer my complicated question!

Answer

A link between inflammatory arthritis and periodontal disease has been proposed.  In fact, before the days of pharmacotherapy for rheumatoid arthritis, a method of treatment was to pull out the teeth.  Still, it remains unclear how the two conditions are related.  It is unlikely, however, that the answer is as simple as a persistent infection.  Likely periodontal inflammation serves as a trigger for joint inflammation, that may persist even when any potential infectious agent has been removed.

Jon Giles, MD

About Jon Giles, MD