1: J Periodontol. 2009 Apr;80(4):535-40.Click here to read Links
Periodontal therapy reduces the severity of active rheumatoid arthritis in patients treated with or without tumor necrosis factor inhibitors.
Ortiz P, Bissada NF, Palomo L, Han YW, Al-Zahrani MS, Panneerselvam A, Askari A.
Department of Periodontics, Case Western Reserve University, Cleveland, OH 44106-4905, USA.
BACKGROUND: Rheumatoid arthritis (RA) and periodontitis are common chronic inflammatory conditions. Recent studies showed a beneficial effect of periodontal treatment on the severity of active RA. This study was undertaken to further examine the effect of non-surgical periodontal treatment on the signs and symptoms of RA in patients treated with or without anti-tumor necrosis factor-alpha (anti-TNF-alpha) medications. The effect of anti-TNF-alpha therapy on periodontitis also was assessed. METHODS: Forty participants diagnosed with moderate/severe RA (under treatment for RA) and severe periodontitis were randomly assigned to receive initial non-surgical periodontal therapy with scaling/root planing and oral hygiene instructions (n = 20) or no periodontal therapy (n = 20). To control RA, all participants had been using disease-modifying anti-rheumatic drugs, and 20 had also been using anti-TNF-alpha before randomization. Probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), gingival index (GI), plaque index (PI), RA disease activity score 28 (DAS28), and erythrocyte sedimentation rate (ESR) were measured at baseline and 6 weeks later. Linear mixed models were used to identify significant differences between subjects who received periodontal treatment and those who did not. RESULTS: Patients receiving periodontal treatment showed a significant decrease in the mean DAS28, ESR (P <0.001), and serum TNF-alpha (P <0.05). There was no statistically significant decrease in these parameters in patients not receiving periodontal treatment. Anti-TNF-alpha therapy resulted in a significant improvement in CAL, PD, BOP, and GI. CONCLUSIONS: Non-surgical periodontal therapy had a beneficial effect on the signs and symptoms of RA, regardless of the medications used to treat this condition. Anti-TNF-alpha therapy without periodontal treatment had no significant effect on the periodontal condition.
Periodontal Gum Disease Around the Tooth Affects 75 Percent of people
The word periodontal actually means “around the tooth.” Most victims are unaware that they have this disease because it is painless, but it affects almost 75 percent of the population. Periodontal, or gum diseases, including gingivitis, are serious infections that when left untreated can lead to tooth loss. Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth.
This disease can affect one tooth or several teeth, and it typically begins when the bacteria in plaque causes the gums to become inflamed. The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. The American Dental Association provides a list of warning signs for periodontal gu disease. Here are some common symptoms:
1.Gums bleed when you brush your teeth 2.Gums are red, swollen and tender 3.Gums have pulled away (receded) from the teeth. 4.There is pus between teeth and gums when gums are pressed. 5.Permanent teeth are loose or separating. 6.There is a change in the way teeth fit when biting. 7.Changes in the fit of partials or dentures. 8.Persistent bad breath.
If you have one or more of any of the above warning signs, you should bring it to the attention of your dentist or hygienist.
How do people get periodontal disease? According to one southern California dentist, “There can be a number of factors; however there is one big reason and that is poor hygiene. If you don’t take care of your teeth and brush and floss them properly on a daily basis, your teeth and gums suffer. Left untreated it can lead to loss of teeth,” said Dr. Bijan Afar. “Chronic periodontitis is more prevalent in adults, resulting in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. Gum disease is typically characterized by pocket formations and recession of the gingival.
We know there are many reasons why people are more prone to periodontal disease. Here are some of the factors: Smoking; genetics, clenching or grinding teeth, pregnancy and puberty, stress, diabetes, medications, poor nutrition, and other systemic diseases such as rheumatoid arthritis, or other health issues that interfere with the body’s immune system, which often worsens the condition of the gums. What’s more, researchers have found links between obesity and periodontal disease
Most periodontists will recommend periodontal surgery if the tissue around your teeth is unhealthy and cannot be repaired non-surgically. There are basically four kinds of treatments that periodontists prescribe. And if it is too late and you have already lost teeth thanks to periodontal disease, you have an option for dental implants, a permanent tooth replacement procedure.
Pocket reduction: Regeneration procedures: Crowns: Soft Gum Tissue Grafts; Pocket Reduction Proceedures; Regenerative Procedures; Crown Lengthening and Soft Tissue Grafts. If you’ve already lost a tooth to periodontal disease, you may be interested in dental implants – the permanent tooth replacement option.
