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Word of mouth rheumas
This article was specifically suggested by my rheumatologist. As an avid follower and supporter of The Rheuma Mill, he urged that I write about oral manifestations of rheumatoid arthritis. Dental issues are common amongst rheumatoid arthritis patients but not many of us realise it! The topic occasionally comes up in support group discussions so I want to raise awareness of this! There is also evidence to suggest that the connection between oral health and RA is not just a one way street. The theory is that some oral diseases can trigger RA. Dental health, in particular, periodontal disease is not just a concern for those living with rheumatic diseases but also for those living with Systemic lupus erythematosus (Lupus), Sjögren syndrome and autoimmune diseases in general.
Rheumatoid arthritis treatment
Oral manifestations are not only due to rheumatoid arthritis but are also due to RA treatment such as Methotrexate. Methotrexate can cause a sore mouth and/or mouth ulcers for which folic acid helps to prevent.
I have never really had any major concerns with my dental and oral health. My teeth have always been pretty good and since having kids, have always consistently visited my dentist twice a year at least. Since my rheumatologist diagnosis, my visits to him have been much more frequent and have involved more than the usual clean. Between tooth infection and rheumatoid arthritis, it seemed like my joints and my teeth were fighting for attention.
Despite hating my trips to see the dentist, there was no way I was going to have bad teeth AND rheumatoid arthritis so these visits were necessary. My visits with Dr. Richard (dentist) got so unpleasant and frequent that at one stage he jokingly stated that I must love seeing him to which I replied, ‘Of course. It’s a party every time.’ So now, at every one of my appointments, he has a balloon tied to the chair for me!
Can rheumatoid arthritis affect your mouth?
Oral manifestations of rheumatoid arthritis for me has meant dry mouth, tooth chipping, teeth grinding and lately, temporomandibular joint issues. Oh what fun! I will go through some of the clinical features of these and how to they relate to RA.
Dry mouth is pretty much what it sounds like, a dry mouth. In saying that, it’s not the dry mouth that you associate with not having had enough water. I, for one, drink at least 3 ltrs (0.8 gal) of water a day. It’s a dryness that doesn’t go away regardless of fluid intake. Dry mouth impacts my taste buds and I sometimes have trouble with swallowing, chewing and speaking. Hoarseness and sore throats can occur too as a result of dry mouth. I usually have to clear my throat before I speak. So attractive!
Rheumatoid arthritis can cause connective tissue disease and inflammation of the salivary glands which impacts salivary flow. Certain anti inflammatory medications such as Celebrex are also known to affect the salivary glands. Saliva plays a big roll in oral hygiene especially in helping to prevent bacteria. The oral cavity is protected from germs by the antibodies found in saliva.
To combat the dry mouth, my dentist recommended Biotene which is a mouth wash. I use it morning and night after brushing my teeth and have found this quite useful. It relieves the dry mouth, as well as acting like a lubricant. This is important for both comfort and for oral health.
Can rheumatoid arthritis affect your gums?
If you suffer from dry mouth, then gum disease can definitely be an issue. With or without dry mouth, periodontal disease is a major concern which can lead to tooth loss. It’s imperative for all those living with RA to stay on top of their oral health. Brushing your teeth, limiting sugar, refrain from smoking and having regular visits to the dentist is crucial. It’s important not to wait until your next dental appointment if your gums are feeling tender and causing discomfort.
Just when I thought that RA couldn’t possibly affect any other part of my body, it started affecting my jaw! It really just came out of nowhere. One minute I’m just sitting there reading a book and the next minute, my jaw feels like it’s come out of it’s socket. Since then, it can sometimes feel locked up or just strained from being locked up. It’s a strange feeling but it’s to do with the temporomandibular joint, that is, the jaw joint. When this happens, I find it uncomfortable to eat, sleep, drink and talk. It’s not painful as such, more of a discomfort… at this stage *sigh*. It can be a little nerve racking because you feel like you need to click the jaw back into place when in reality, it’s not actually out of place. As if this disease couldn’t get any more strange!
When my jaws go all funny like this, I steer clear from certain foods such as hard, sticky or chewy foods. I basically avoid moving my jaw as much as I can. I also wear a dental guard / spacer throughout the day which, is like a mouth guard but very thin. This helps relieve the clenching and prevents my teeth from grinding when I do clench. It is very comfortable to wear as they are very thin and custom made to fit you. You can get them from your dentist.
Oral manifestations of rheumatoid arthritis are a real thing! There is a known connection between inflammatory disease and oral health. It is important to know this so you can be on top of your oral and dental care. If you haven’t seen the dentist for a while, it’s important to do so and to discuss with your dentist regarding your ongoing care. In my humble opinion, there is no pain like a toothache so it’s something that I personally avoid like the plague! However, rheumatoid arthritis affects your teeth beyond a tooth ache. It could literally cause your teeth to fall out! So take care of your teeth and they will take care of you.