How Gut, Periodontal Disease & Rheumatoid Arthritis Are Linked

What if I told you that your gums could indicate the health of your immune system? Well, it’s true — and in the case of autoimmune reactions, the connection between your gut, where your immune system “lives”, and your gums, the more you know, the better chance you have of preventing disease in the future.

Recently, research has shown us that a specific autoimmune condition, rheumatoid arthritis, is very closely linked with the progression of periodontitis (gum disease). And at the root of all of this: gut health.

Your gut has everything to do with the manifestation of periodontal disease (PD) and rheumatoid arthritis (RA).

This research is still new to many dentists and traditional healthcare providers, but the news is spreading. An increased risk of autoimmune responses like those in RA is a big deal, particularly in otherwise healthy individuals.

Current Medical Science, Gut Health, & History

Sometimes, science proves that what was thought to be untrue in the past to be true now.

Sometimes, science proves things that were thought to be true in the past to ultimately be untrue in the future.

And sometimes, what was thought to be true hundreds of years ago (but lost its impact over time) becomes the newest news today.

Specifically, some medical research today is uncovering an important truth and confirming what was believed hundreds of years ago.

The truth is that a healthy gut and its healthy garden of bacteria are critical for the avoidance of most – if not all – chronic diseases. Interestingly, this was believed over 2,000 years ago.

Hippocrates, the “Father of Medicine”, was reported to say, “all disease begins in the gut”. Maybe he knew something that we are just beginning to relearn and that medical investigators are just beginning to prove.

Fortunately for us and for the entire medical profession, the newest research is shining a new and vital light on the importance of a healthy gut and the overall health of the human body.

The food we eat, the substances we avoid, and our overall lifestyle affect gut health. Specifically, these affect the bacteria in the gut, the gut’s protective mucosal layer, and the all-important epithelial layer that separates the lumen of the gut from the rest of our body.

The healthy gut lining is the gatekeeper between what’s inside the gut and what’s inside the body. This one-cell-layer-thick gut lining allows necessary digested nutrients to enter our bloodstream. The same lining also protects us from all the other junk in the gut that the body does not need. The junk gets eliminated and the nutrients get absorbed.

Once the nutrients are inside our bloodstream, they help every cell do what each cell was designed to do – to keep us healthy and functioning properly.

Today, many scientific articles have been published that prove the direct causal effects of gut bacteria on the health of various organ systems. One recent peer-reviewed paper describes two very serious but related diseases that may be the result of a damaged gut.

2019 Research Linking Gum Disease to Rheumatoid Arthritis

In 2019, a medical analysis was published in the International Journal of Molecular Sciences titled, “Linkage of Periodontitis and Rheumatoid Arthritis: Current Evidence and Potential Biological Interactions.”

This paper suggested some common causes of periodontal disease and rheumatoid arthritis. If you connect the dots, one likely common cause is a damaged gut.

In essence, this investigation supports the theory that periodontal disease and rheumatoid arthritis may have their beginnings in an unhealthy gut. Yes, the gut!

If this theory is correct, then your dentist and physician need to collaborate on treatment. They could offer effective healing modalities for both periodontal disease (PD) and rheumatoid arthritis (RA) as well as treatment to heal a damaged gut and prevent further progression of PD and RA.

What is periodontal disease (PD)?

PD is the most common cause of tooth loss and one of the world’s most prevalent chronic inflammatory diseases. PD includes gum inflammation (gingivitis) and the more advanced periodontitis, where the jawbone becomes infected.

The prevalence of PD is at epidemic proportions. In 2010, a published paper showed that 93.9% of adults in the United States had some form of gingivitis (almost always caused by the P. gingivalis bacteria).

In 2012, the Centers for Disease Control and Prevention (CDC) published their results in the Journal of Dental Research. The report was updated in 2015 in the Journal of Periodontology.

It showed the prevalence of periodontitis was estimated to be 47.2% for American adults (approximately 64.7 million people at the time of the study). For adults 65 years old and older, the prevalence of periodontitis jumped to 70.1%. That’s huge!

These findings were the result of the most comprehensive periodontal evaluation performed ever in the US.

Periodontal disease develops when unhealthy periodontal bacteria accumulate around the teeth margins and penetrate the gum tissues. These bad bugs eventually could progress into the jawbone that holds the roots of the teeth in the jaw, leading to bone loss, tooth loss, and painful tooth sensitivity.

If a person’s immune system is strong, then periodontal disease may never get started. If a person’s immune system is weak, then harmful oral bacteria could create gingivitis, then possibly severe periodontitis and tooth loss, and ultimately a spread of infection to other areas of the body. Poor oral health almost always translates to poor overall health.

What is rheumatoid arthritis (RA)?

RA is a chronic autoimmune disease, one of the inflammatory conditions known as rheumatic diseases that impact joints and connective tissues. (For context, autoimmunity happens when the immune system recognizes healthy cells as foreign.)

RA patients experience synovial inflammation and hyperplasia leading to irreversible damage of the cartilage and bone in the joints, loss of function, chronic pain, and progressive joint disability.

There are many causes of RA, but many of them are the same for PD.

The Periodontal Disease/Rheumatoid Arthritis Gut Connection

It appears that Hippocrates got it right over 2000 years ago. The gut microbiota is the initial starting point for most, if not all, chronic diseases in humans.

Unhealthy changes in gut bacteria will create a weakened immune system with results spreading into the mouth. When the immune system is compromised, the healthy bacteria in the mouth could change and allow specific bacteria (like periodontal pathogens Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans) to overgrow.

Both of these bad bacteria could lead to local protein alterations by a process called “citrullination”.

Citrullination is the conversion of the amino acid arginine into the amino acid citrulline. Evidence suggests that increased citrullination may participate in tissue destruction associated with periodontal disease and rheumatoid arthritis. Citrullination may be a key mechanism allowing both PD and RA to affect one another.

The path seems clear to me. Physicians and dentists need to integrate their therapies to treat periodontal disease and rheumatoid arthritis efficiently and effectively.

Treating an unhealthy gut will not automatically treat periodontal disease or rheumatoid arthritis — there are many other factors, such as changes in oral hygiene or procedures such as scaling and root planing.

Likewise, only treating PD or RA will not treat an unhealthy gut.

Therefore, a healthy gut should be an important therapeutic goal in order to provide all-inclusive treatment for PD and RA — and, by extension, all systemic diseases.

I have developed a Protocol to Restore Normal Gut Bacteria. Download it by clicking the button below.

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Dr. Al is the top nutritional periodontist in the world. He still works regularly with clients via online/telemedicine consultations. To schedule an online consult with Dr. Al, click here.