Abstract

Rheumatoid arthritis (RA) is an immune-mediated inflammatory disease (IMID), chronic progressive causing inflammation in the joints and resulting in painful deformity and immobility, especially in the fingers, wrists, feet, and ankles. Periodontitis is defined as an inflammatory disease of supporting tissues of teeth caused by specific microorganisms or their groups, resulting in progressive destruction of the periodontal ligament and alveolar bone with periodontal pocket formation, clinical attachment loss, or both. Individuals manifesting both periodontitis and RA may suffer from a unifying underlying systemic dysregulation of the inflammatory response. In the past few years, increasing attention has been given to aspects of oral health in patients with rheumatoid arthritis, especially related to associations with periodontal disease. In this chapter we will be reviewing about the pathophysiology of RA and role of inflammation, periodontal disease: a gateway to RA, oral manifestations of RA, immunogenetics of RA and periodontitis, treatment implications for RA and periodontitis based on common pathophysiology.

Highlights

  • The global rheumatoid arthritis (RA) prevalence estimate was 0.46%

  • The cross-sectional study was conducted to assess the impact of periodontitis (PD) on the health-related quality of life (HRQoL) and oral health-related QoL (OHRQoL) of subjects with rheumatoid arthritis (RA) and periodontal disease (PD) and found that the interaction effect of both diseases significantly conferred impacts on their OHRQoL and HRQoL [3]

  • Periodontitis is an inflammatory disease affecting periodontium caused by specific microorganisms like P. gingivalis (Pg), Aggregatibacteractinomycetemcomitans

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Summary

Introduction

The global RA prevalence estimate was 0.46%. Women are affected 2 to 3 times more often than men. Periodontitis is an inflammatory disease affecting periodontium caused by specific microorganisms like P. gingivalis (Pg), Aggregatibacteractinomycetemcomitans. Rheumatoid Arthritis (Aa), T. denticola, T. forsythia These bacteria are noted in the serum and synovial fluid of the joints of RA patients [4]. Several epidemiologic studies have described associations between rheumatoid arthritis and periodontal disease. Recent clinical studies are increasingly linked with biological assessments to better understand the nature of these relationships These elicit the body to create antibodies – known as autoantibodies that include rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (anti-CCP) in turn produces tumor necrosis factor-alpha (TNF-α), Interleukin (IL)-1, IL-6, IL-8, transforming growth factor-beta (TGF-β), fibroblast growth factor (FGF) and platelet-derived growth factor (PDGF) that damage the body’s cartilage, bone, tendons, and ligaments, resulting in the symptoms of RA [7]

Periodontal disease: a gateway to RA
Oral manifestations of RA
Immunogenetics of RA and periodontitis
Findings
Conclusion
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