Question
I was diagnosed with RA in 2000. While in Florida a Rheumatologist told me that I had Psoratic Arthritis and increased the dosage of Humira from once every 2 weeks to one a week. That was in June 2008. In May 2008, I was treated for an abscessed tooth. While the tooth was very infected with pus draining, etc I did not feel any pain. I ended up with 3 teeth being for severe abscesses. In the time since May, I have had 3 more teeth with severe abscess. The endodonist suggests that since humira limits the imune system that it may be the cause. I have not had any pain with any of the dental problems. I have seen different endondist and it appears that the diagnosis is correct especially with the drainage from the tooth. I am currently being treated for two teeth with a root canal on both and then the dentist will place a new crown on each one. What is your opinion as to the cause of all the dental problems that have occurred this past year? Eventually, I should run out of teeth needing a root canal. It is scary that there is no warning or pain associated with the problem. I am 67 years old and many of my teeth have crowns and caps. Please help me with this problem.
Answer
HI Delores,
You ask an extremely interesting question. In fact, peridontal disease is found in much higher frequency in patients with RA than in individuals without RA. The same hasn’t been reported for psoriatic arthritis, to my knowledge. This may suggest a common link in the pathogenesis of the two illnesses, giving us a clue that bacteria in the mouth could trigger RA. At any rate, periodontal disease is also very common as we get older. The biggest risk factors are smoking and poor oral hygiene. So, in addition to whatever the dentist recommends, strict attention to oral hygiene, discontinuing smoking (where appropriate),and tight mangaement of the arthritis are all important in trying to get the process under control.
