Gum Disease May be an Initiator of Arthritis

Abstract

How many times has it happened that you had a toothache or pain in your gums and you consulted a dentist or any general physician? It might be very rare when we go and consult doctors in such a case. We either take a pain killer or simply change our toothpaste, right? But what if this is an early sign of some changes that are going on in your body? In this article, we will try to understand the association between gum diseases and arthritis.

Introduction

In medical science, gum disease is known by the term Periodontitis. If left untreated, an infection might reach the bone that supports the teeth, resulting in loosening of teeth. Bleeding from the gums while brushing, or pain in the gums on touch are common manifestations of gum disease.

Causes of Gums Disease

1. Bad oral hygiene
2. Plaque formation on teeth

Symptoms

1. Bleeding from gums
2. Bad smell
3. Swollen gums
4. Pus formation between gums and teeth
5. Pain while mastication
6. Tenderness on touching gums

Relation of Gum Disease and Arthritis

The bacteria responsible for gum disease can enter the bloodstream and can cause complications in other parts of the body.  Gums disease is associated with arthritis not only in adults but also in children with idiopathic juvenile arthritis (JIA). A 2010 study conducted by the Journal of Periodontology concluded that rheumatoid arthritis patients were twice as susceptible to gum disease. In recent times, with the help of tools like DNA sequencing has been concluded that the germs causing gum diseases also contribute to other health disorders like inflammatory disorders like rheumatoid arthritis. These researches that we are referring to are based on the fact that microbiome or microbiota that are present in the human body are beneficial in many ways like they are helping in digestion and protection against inflammation. But in situations where there is a change (mutation), in these microbiomes or microbiota like in the case of periodontal disease, may result in an immune response that starts targeting the body's own tissue.

How Bacteria in the Mouth can Harm the Joints

The way to see how rheumatoid arthritis might have started has changed in recent years. Some evidence is now pointing that rheumatoid arthritis does not start in the joints but from autoantibodies which are being produced in other parts of the body e.g digestive system.

What is Citrullination

It is important to know some changes that occur in rheumatoid arthritis. Citrullination is the conversion of arginine (one of the 20 amino acids) into citrulline. Unlike arginine, citrulline is not positively charged rather it is neutral. This leads to increased hydrophobicity of the protein and changes in its basic structure and functioning. Thus, the immune system starts attacking this protein, perceiving it as a threat. Now, the same process goes in the mouth, as the microbes in the buccal cavity are good at creating autoantibodies. One of the best examples of such microbes is P.gingivalis (Porphyromonas gingivalis)

Earlier researchers used to assume that periodontal diseases had a wide spectrum of effects on general health due to systemic inflammation. That is why it was seen as being associated with several health conditions like renal disease, heart disease, and or rheumatoid arthritis. But, since the presence of the oral bacteria has been found in the synovial fluids of the joints of patients with rheumatoid arthritis and osteoarthritis as well. It now seems that bacteria got access to different sites of the body, once escaping from the mouth.

Ayurvedic point of view in gum disease and arthritis

In an Ayurvedic context, there is proper classification of diseases with causes and symptoms described in a channelized way. According to the ayurvedic concepts there are three doshas present in the human body; Vata, Pitta, and Kapha. These doshas are formed with the combination of five elements i.e Space, Air, Fire, Water, and Earth. Vata is a combination of Space and Air, Pitta is the result of merging of Fire and Water and Kapha is the combination of Water and Earth elements. They co-exist in a harmonious way in a healthy human being. A disease is caused by an imbalance in one of these doshas only. In the case of arthritis there is an imbalance in Vata dosha, and accumulation of Ama takes place in the joints.

To understand this, we need to learn about Asthivah srotas. In the ayurvedic concept, it is believed that teeth and nails are derived from the bones, and any malfunctioning in the bones or joints can be seen in the form of disorders of teeth, nails, gums, and hair as early signs that indicate bone status. The main causes of the arthritis according to Asthivah srotas are injury, grief, excessive exercise, pressure, friction and excessive consumption of vata diet that is bitter, astringent and pungent foods. Symptoms of the vitiation of asthi vaha srotas i.e bone carrying channels are brittle nails, deformed nail bed, falling of hair and body hair, extra growth of teeth, toothache, diseases of the skin pores, splitting pain in bones, and excessive tiredness.

Precautions to Avoid Vitiation of Vata Dosha

1. Avoid excessive exercise
2. Do not expose yourself to extreme cold weather, if required then put on warm clothes.
3. Do not consume foods that aggravate Vata dosha like bitter, pungent and astringent foods. For example, raw food is not easy to digest, all citrus fruits, pomegranate, dry fruits and potatoes, raw onion, tomatoes. Also, white sugar and fatty oils are to be avoided
4. Soft food is advised as soup, which should be homemade
5. Light exercise like walking
6. Massaging with oil in a gentle manner
7. Steam bath in order to keep your body warm

Conclusion

The disorder in the bones in the human body is related to the corrupted asthi vaha srotas. The result is excessive deposition of bone tissue or cells which takes part in the formation of bone tissue. When vata aggravates bone, it leads to damage of tissue. Therefore, it could be said that any manifestations in gum diseases or teeth disease can be early signs of bone disorders that are going to happen in the future as they are also made up of bones. It could be concluded that these early signs should not be ignored as the result could be devastating. A healthy lifestyle is also a necessity of time. Having a good lifestyle that is free of stress, and full of gratitude is a key to a healthy body.