Rheumatoid Arthritis and Diabetes

Treatment for one found to relieve the other.

Charles W Martin By Charles W Martin, DDS
Founder, DentistryForDiabetics.com

The inflammation of gum disease can make it difficult to participate in physical activities that help you keep up with your diabetes control efforts. Why? Because researchers at Case Western Reserve University School of Dental Medicine and University Hospitals of Cleveland have confirmed a link between a severe form of rheumatoid arthritis and gum disease. Their study examined people who had a particularly severe type of rheumatoid arthritis and moderate to severe gum disease.

What did they learn? Quite a bit. And while no one is ready to say that gum disease causes rheumatoid arthritis, scientists did find that treating gum disease improved the arthritis symptoms in the participants in the study. After the gum disease was treated, participants had reduced arthritic pain, fewer swollen joints, and less stiffness in the morning.

This is particularly interesting since one of the long-held beliefs of many medical professionals is that gum disease plays a big role in systemic diseases like rheumatoid arthritis. One of the older treatments for rheumatoid arthritis was tooth removal and antibiotics. Of course that treated the gum disease along with providing patients with relief for their stiff and painful joints.

Why is gum disease believed to be linked to rheumatoid arthritis? And are there ways that this can affect you as a person with diabetes beyond the fact that stiff and painful joints can limit your physical activity?

Identifying the Links

Well, first we need to take a look at our old enemy – inflammation. Rheumatoid arthritis and gum disease are both inflammatory diseases and, unchecked, they can do serious soft and hard tissue damage over time.

In the mouth, when the bacteria associated with gum disease colonize under the gum line, the body responds to the inflammation that accompanies the infection. When the immune system responds, it often does so in ways that can interfere with blood sugar control. Treatments for gum disease like root scaling and planing, especially when coupled with antibiotic therapy, can drop one to one and a half points off your A1C level as well as ease your joint pain.

Scientists have discovered that more than half of all people who have rheumatoid arthritis also have gum disease and its accompanying problems: fewer teeth, more plaque, and more attachment loss which leads to tooth loss.

Another finding is that the rheumatoid arthritis is significantly worse in those who also have gum disease. A common treatment for rheumatoid arthritis focuses on reducing the inflammation that is a central part of the disease. After six months of treatment for inflammation, studies have shown that there is also improvement in the level of gum disease.

That connection is no real surprise for those of us who have studied the links between the inflammation of gum disease and other inflammation-related conditions. I look forward to further research to find more connections along the inflammation pathway between gum disease and a host of systemic health issues including heart disease, rheumatoid arthritis, and diabetes.

For more information about dental care for people who have diabetes, visit http://www.dentistryfordiabetics.com and Dr. Martin's blog, http://www.dentistryfordiabetics.com/blog.

To learn more about the two-way connection between diabetes and gum disease, check out the other columns here on dLife or Dr. Martin's book, Don't Sugar Coat It.

Read Dr. Charles Martin's bio here.

Read more of Dr. Martin's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition. 

Last Modified Date: July 01, 2013

All content on dLife.com is created and reviewed in compliance with our editorial policy.

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by Brenda Bell
Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...
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