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Home / Arthritis News / Dental Tips for the Rheumatoid Arthritis Patient

Dental Tips for the Rheumatoid Arthritis Patient

January 11, 2016 By Arthritis Center

Key Points

  • Sjögren’s syndrome can cause inflammation damaging the glands that secrete fluids such as salivary glands. This can lead to cavities through the mouth, severe oral dryness, difficulty eating, and even tooth loss
  • Arthritis can affect the temporomandibular joint (TMJ) that opens and closes the mouth sometimes making it painful to open and close your mouth.
  • Different oral Infections can also occur:
    • Bacterial infections can cause swelling around your tooth or over the jaw, severe pain, fever, and swollen nodes around your jaw
    • Fungal infections can cause a white coating or clumping that can develop on the tongue or around the inside of your cheeks.
  • Oral ulcers can also occur in people taking methotrexate. A folic acid supplementation can help with reducing ulcers.
  • Brush and floss regularly, avoid chewing tobacco and smoking cigarettes. Be sure to see a dentist regularly and tell your doctor or treating rheumatologist about any new oral health issues.

Oral health and Inflammatory Diseases

Postdoctoral research fellow Malini Moni, BDS, MS shares information and tips about common oral health problems seen in patients living with rheumatic diseases. Pain from these autoimmune diseases can make it difficult for some people to brush or floss their teeth.

A study conducted at the Johns Hopkins Arthritis Center found that gum disease and tooth loss are more prevalent in people who have rheumatoid arthritis (RA). Another syndrome that is known to hinder oral health is Sjögren’s syndrome. This syndrome can be seen in people who have rheumatic diseases.

Sjögren’s syndrome seen in those with Rheumatoid Arthritis

Sjögren’s syndrome is an autoimmune condition that can occur alone or in conjunction with another autoimmune disease. In this disease, inflammation causes damages to the glands that secrete fluid such as the salivary gland and even the glands that create tears. Sjögren’s can lead to cavities through the mouth, severe oral dryness, difficulty eating, and even tooth loss. More information about Sjögren’s syndrome can be found on our website.

Salivary glands that are damaged cause dry mouth, sticky, saliva, difficulty swallowing, and trouble with food being stuck in the throat. If a salivary gland is badly blocked it can become infected causing severe pain and swelling in the gland. Having a lack of saliva creates problems for the health of your teeth. Saliva is not only a lubricant to help food pass through your throat; it also has proteins that reduce the bacteria in your mouth.

To help trigger a salivary response try using a throat lozenge or sugar free candies. Make sure that you are frequently drinking fluids. After brushing, it can be helpful to use a fluoride rinse such as ACT or Colgate FluriGard. You can also use an alcohol-free mouthwash such as Biotene, also, look in your grocery store for dry mouth toothpaste.

Arthritis Can Affect the TMJ

Arthritis can affect the joint in your jaw (temporomandibular joint or TMJ) that opens and closes the mouth. Inflammation can form along the tendons, this can cause damage affecting the joint and making it painful or difficult to open your mouth. It is important to recognize these symptoms if you have RA or other forms of arthritis. Specific types of x-rays can help to get a better picture of this joint to see if there are any problems with inflammation. Using a bite guard at night can help reduce your symptoms of TMJ.

Be Aware of Infections in Your Mouth

Bacterial infections of the mouth can be a problem for people who are taking immunosuppressive medications. Signs of infections include swelling around your tooth or over the jaw, severe pain, fever, and swollen nodes around your jaw.

It is also important to be aware of fungal infections such as Candida or Oral Thrush. These infections bring about a white coating or clumping that can develop on the tongue or around the inside of your cheeks.

People taking Methotrexate can sometimes have oral ulcers. These ulcers can be painful and uncomfortable; however, taking a folic acid supplementation can help reduce the ulcers. It may also be helpful to have a mouthwash with a numbing medication if the ulcers are very painful.

It is important to let you doctor know if you develop any of these symptoms so you can receive treatment as soon as possible.

What can you do for better oral health?

Oral health can impact your physical health, make sure to brush and floss your teeth regularly. If holding a regular toothbrush is difficult or painful, switch to a large grip battery powered toothbrush. Cigarette smoking and chewing tobacco can worsen oral conditions.

Be sure to see a dentist on a regular basis, talk to your doctor and treating rheumatologist about and new oral health problems.

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