Rheumatoid Arthritis

Gabrielle
Rheumatoid Arthritis (RA)

● Severe autoimmune disease that involves multiple joints

● Characterized by chronic inflammation
● Joints most affected:
○ Hands, feet, wrists, and knees
○ Fingers can also be affected
● Chronic pain and potential deformity
Manifestations: Treatment:

● Tender and swollen joints ● Inflammatory drugs

● Morning joint stiffness (NSAIDs)
● Bi-lateral ● Immunosuppressives
● Generalized sickness ● DMARDs
○ Weight loss ● Steroids
○ Fever ● Physical & occupational
○ Fatigue therapy
Diagnosis:
Combination of manifestations in
addition to more in-depth labs and
imaging
RA and Oral Health
Oral Infections:
● Gingivitis
● Periodontitis
● Sjogren’s Syndrome
● Loss of motion in the TMJ
● Other oral infections
○ Fungal and bacterial
Treatment Issues:
● Periodontal disease
● Dry mouth (caries)
● Ulcers
● Bleeding gums
● Oral thrush
Dental Considerations

● Update patients health history

● Homecare modifications
○ Large grip electric toothbrush
○ Handheld flosser
○ Resting elbow while brushing/flossing
● More frequent cleanings
● Discuss other medication options
Summary
● Routine oral care is an important part of oral health
● Those with severe joint pain or limited mobility can create a plan with
their dental professional to manage homecare and come in for more
frequent cleanings
● It is important as a dental professional to know what medications patients
are taking to better educate on the negative side effects to oral health
● With a combined plan, the patient and clinician can work together to
avoid worsening or oral infection
References
Centers for Disease Control and Prevention. (2020, July 27). Rheumatoid Arthritis (RA). Centers for Disease Control and Prevention.
https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html.

Delta Dental. (2017, July). The Link Between Rheumatoid Arthritis and Oral Health. The link between rheumatoid arthritis and oral health.
https://www.deltadentalins.com/oral_health/rheumatoid-arthritis.html.

Dilling, W. (2020, April 1). Brushing and Flossing with Arthritis Pain. https://www.deltadentalia.com/a-healthy-life/dental-health/brushing-teeth-with-
arthritis/.

Lin YJ, Anzaghe M, Schülke S. Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis. Cells. 2020 Apr
3;9(4):880. doi: 10.3390/cells9040880. PMID: 32260219; PMCID: PMC7226834.

Mayo Foundation for Medical Education and Research. (2021, May 18). Rheumatoid Arthritis. Mayo Clinic. https://www.mayoclinic.org/diseases-
conditions/rheumatoid-arthritis/diagnosis-treatment/drc-20353653.

National Rheumatoid Arthritis Society. (2020, December 10). Oral Health and Rheumatoid Arthritis (RA). National Rheumatoid Arthritis Society.
https://nras.org.uk/resource/oral-health/.