Jim Erpenbach DDS

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Researchers Find Rheumatoid Arthritis May Be Caused by Mouth Bacteria

Rheumatoid arthritis is a painful joint condition suffered by 1.5 million Americans according to the Centers for Disease Control. The condition, also known as RA, is an autoimmune disorder in which the body’s immune system targets healthy synovial tissue located around the joints. Rheumatoid arthritis can be triggered by illnesses or certain medical conditions, but researchers at Johns Hopkins University have found a link between RA and a particular type of bacteria found in the mouth. These new findings may lead to new treatments for patients suffering from RA, as well as methods of prevention.

These bacteria are known to cause periodontal infections but have also been found to cause RA. These bacteria confuse the body, which mistakes its own tissue as foreign invaders. This confusion prompts an immune system response in order to destroy these imagined foreign bodies by attacking the tissue of the synovium. The synovium, also known as the synovial membrane, is the soft tissue found in the joints that serve to cushion the joints as they move or glide.


The Johns Hopkins study was published in the journal, Science Translational Medicine, and shows the discovery that a common factor in RA patients was periodontal gum infections. The study examined 196 RA patients, and found that almost half were infected with A.actinomycetecomitans. Scientists on the study believe that this particular bacterium produces proteins that aggravate the immune system into its attack response.

The discovery of this link is exciting for both RA researchers and dentists. One particular dentist that is excited about this new research is Dr. James Erpenbach, D.D.S. Erpenbach is a Knoxville, Tennessee, dentist and a founding member of the American Association of Oral-Systemic Health.

"Science and medicine are continuously proving a connection between the mouth and the rest of the body," Erpenbach said. "By examining the connection between RA and A.actinomycetecomitans, a root cause of the condition may be uncovered – which means potential relief for RA sufferers."

The John’s Hopkins study isn’t the first time the connection between RA and periodontal infections has examined. However, early researchers believed that both conditions were caused by another common denominator, another type of bacteria, P. gingivalis. This bacterium is a well-known well cause of periodontal infection.

Researchers were led to the link between A.actinomycetecomitans because of the similar reactions found in the gums and the joints of patients infected with the bacteria. Both locations had a high level of proteins. These proteins cause inflammation and the body’s self-attack response. In fact, RA researchers on the project found that A.actinomycetecomitans was the only bacterium able to produce such a response.

Rheumatoid arthritis does not just impact the joints, it attacks the whole body. Organs can be affected, as well as muscle and other types of connective tissue. RA is characterized by pain and swelling. These symptoms can seriously impact a person’s quality of life, and in some cases cause them to become permanently disabled. Some RA sufferers also face crippling joint deformities.

Current treatments for rheumatoid arthritis include steroids and anti-inflammatory medications, which can lead to further complications.

"Imagine being able to restore an RA patient’s quality of life through dental therapy for gum infections," Erpenbach said.

Gum infections are caused by bacterial infections that often result from poor dental hygiene.Plaque can be brushed away, but patients have to actually do it. If plaque is allowed to persist, it develops into gingivitis and then into gum disease

"Bacteria thrive in dental plaque. Plaque is the sticky film that covers the teeth and other tissues of the mouth between brushings," Erpenbach said. "Once a patient has gum disease, treatment becomes a little more difficult."

Other complications of periodontal disease include cardiac and pulmonary implications and dementia. Patients should take care to brush and floss daily, and visit their dentist at least twice per year.

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